脑出血患者急性期血小板活化与血肿内炎性反应关系的研究  

Study on the relationship of platelets activation and inflammatory reaction in hematoma at acute phase of intracerebral hemorrhage

作　　者：张国华[1] 林杰[1] 陈彩肖 张军[1] 王珊[1] 史福平[1] 刘一鸥[1] 

机构地区：[1]河北医科大学第二医院神经内科 [2]新乐市中医院

出　　处：《临床神经病学杂志》2006年第4期263-265,共3页Journal of Clinical Neurology

基　　金：河北省自然科学基金资助项目(C2005000748)

摘　　要：目的研究脑出血患者血肿内白细胞浸润及其与血小板P选择素(CD62p)、血小板膜凝血酶敏感蛋白(TSP)表达的关系。方法33例行微创手术的脑出血患者,手术时留取血肿液及静脉血,用流式细胞术(FCM)检测其血小板CD62p、TSP的表达及白细胞计数,并对血肿内白细胞浸润与血小板CD62p及TSP之间进行相关性分析。结果脑出血组血肿液中血小板CD62p、TSP表达(20.25±1.82,37.04±3.63)显著高于静脉血(7.72±2.19,12.32±2.81)(均P<0.01);且均显著高于正常对照组(3.81±1.78,8.67±2.86)(均P<0.01)。脑出血后血肿内白细胞浸润与血肿液中血小板CD62p、TSP的表达呈显著正相关(r=0.5374,P=0.0013;r=0.5468,P=0.0010),与静脉血中血小板CD62p、TSP的表达亦呈显著正相关(r=0.4401,P=0.0104;r=0.4288,P=0.0128),前者比后者相关性更为显著。结论脑出血急性期血肿内出现以白细胞浸润为特征的炎性反应,并出现血小板活化,活化的血小板可能参与了血肿内的炎性反应。Objective To investigate the leukocyte infiltration inside the hematoma and the correlation between this and the expression of platelet P-selectin （CD62p） and platelet thrombin-sensitive protein （TSP） of patients with cerebral hemorrhage. Methods In 33 patients with cerebral hemorrhage treated with minimally invasive surgery, the expressions of platelet CD62p and TSP were detected by flow cytometry （ FCM ） and leukocyte counts were measured in intracerebral hematoma fluid and venous blood. The correlation analysis was performed between the two variables. Results The expressions of platelet CD62p and TSP in hematoma fluid were higher in patients with acute cerebral hemorrhage （20.25±1.82, 37.04±3.63） than those in venous blood （7.72 ±2.19, 12.32 ±2.81）（all P〈 0. 01 ） and those in healthy individuals （ 3.81± 1.78, 8.67 ± 2.86） （ all P 〈 0. 01 ）. There was a significant positive correlation between the level of CD62p and TSP expressed on the platelets surface and the count of infiltrating leukocytes inside the hematoma after ICH （ CD62p ： r = 0. 5374, P = 0. 0013 ;TSP： r = 0. 5468, P = 0. 0010）, and there was a positive correlation between the level of CD62p and TSP expressed on the platelets surface in the venous blood of ICH patients and the count of infiltrating leukocytes inside the hematoma after ICH （CD62p： r =0. 4401, P =0.0104;TSP：r=0.4288, P =0.0128）. Conclusions A severe inflammation reaction does occur in blood clot after ICH. Platelets in patients with acute cerebral hemorrhage are also markedly activated, which is possibly related to the process of leukocyte infiltration in the blood clot after ICH.

关 键 词：脑出血 血肿液 白细胞浸润 活化血小板 炎性反应 

分 类 号：R743.34[医药卫生—神经病学与精神病学]