脑出血患者急性期血小板活化的临床意义  

Clinical significance of platelets activation in patients with acute cerebral hemorrhage

作　　者：林杰[1] 张国华[1] 史福平[1] 张军[1] 王珊[1] 邸卫英[1] 

机构地区：[1]河北医科大学第二医院神经内科

出　　处：《临床神经病学杂志》2006年第5期385-387,共3页Journal of Clinical Neurology

基　　金：河北省卫生厅医学科学研究重点课题计划(04049)

摘　　要：目的探讨脑出血(ICH)急性期血小板活化的临床意义。方法33例行微创手术的ICH患者,术前经头颅CT测量血肿周围脑水肿带的大小,术中留取血肿液及静脉血,用流式细胞术(FCM)检测其血小板表面糖蛋白P-选择素(CD62p)和血小板膜凝血酶敏感蛋白(TSP)的表达,并与所测水肿带大小进行相关性分析。结果CD62p、TSP在ICH组的表达显著高于健康对照组,ICH组血肿液中其表达量显著高于静脉血中的表达;血肿液中血小板CD62p、TSP的表达与血肿周围脑水肿程度呈显著正相关(r=0.4781,r=0.5183,均P<0.005);静脉血中血小板CD62p、TSP表达量与血肿周围脑水肿程度呈显著正相关(r=0.4058,r=0.4193,均P<0.05),前者比后者相关性更为显著。结论ICH急性期血小板活化,活化的血小板可能参与了血肿周围脑水肿的形成。Objective To study the platelets activation in patients with acute cerebral hemorrhage and its significance in peribematoma edema. Methods 33 patients with cerebral hemorrhage were treated with minimally invasive surgery. The volume of edema perihematoma was determined by CT technique before operation. The expressions of platelets CD62p and TSP in intracerebral hematoma fluid and venous blood were detected by flow cytometry （FCM）. The correlation between the two variables was also analyzed. Results The expressions of platelets CD62p and TSP were higher in patients with acute cerebral hemorrhage than those in healthy individuals, and the expressions of platelets CD62p and TSP in intracerebral hematoma fluid were higher than those in venous blood. There were significant positive correlations between the expression levels of CD62p and TSP from the surface of platelets in hematoma and the edema size perihematoma （ CD62p ： r = 0. 4781, TSP ： r = 0. 5183, all P 〈 0. 005 ）. The positive correlations were also found between the expression levels of CD62p and TSP on the surface of platelets in venous blood and the edema size perihematoma. （CD62p：r =0. 4058 ,TSP： r =0. 4193, all P 〈 0. 05 ）. Conclusion Platelets activation is found in patients with acute cerebral hemorrhage and it may be involved in edema formation perihematoma.

关 键 词：脑出血 血肿液 血小板活化 脑水肿 流式细胞术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]