低高密度脂蛋白胆固醇血症对血小板胞浆游离钙及释放反应的影响  

The effects of plasma low high-density lipoprotein cholesterol on platelet cytosolic free calcium and release reaction

作　　者：骆雷鸣[1] 李妍涵[2] 王金惠[3] 刘静[1] 薛浩[1] 曾强[1] 吴红梅[1] 叶平[1] 

机构地区：[1]解放军总医院南楼心血管二科,北京100853 [2]中国医学科学院血液研究所,天津200210 [3]中国军事医学科学院,北京100039

出　　处：《中国实用内科杂志》2007年第8期608-610,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的观察低高密度脂蛋白胆固醇(HDL-C)血症对血小板胞浆游离钙([Ca2+]i)及血小板释放反应产物β-血小板球蛋白(β-TG)、血小板因子4(PF4)的影响,探讨HDL-C降低在动脉粥样硬化(HDL-C)和血栓性疾病中的致病作用。方法在2003—2004年解放军总医院体检者中,随机入选单纯HDL-C降低的患者42例,应用荧光探针Fura 2-AM标记和酶联免疫吸附试验(ELISA)技术,测定该组患者及25例健康对照(CONT)血小板[Ca2+]i、血浆β-TG和PF4浓度。结果同CONT组相比,LHDL-C组血小板[Ca2+]i升高(P<0.01),血浆β-TG(P<0.01)和PF4也显著升高(P<0.01)。LHDL-C组HDL-C除与[Ca2+]i呈负相关(P<0.01)外,与β-TG和PF4浓度也呈负相关(P<0.01;P<0.01),血小板[Ca2+]i与β-TG和PF4呈正相关(P<0.01;P<0.01)。2组[Ca2+]i均与β-TG和PF4呈正相关(P均<0.01),β-TG与PF4比值均稳定在3左右。结论结果提示低HDL血症可能通过升高血小板[Ca2+],诱发血小板活化和释放反应增强,释放产物可能直接参与动脉粥样硬化和血栓性疾病的发病过程。Objective To discuss pathogenic effects of low high-density lipoprotein cholesterol（HDL-C） on atherosclerosis and thromboembolism,the influences of HDL-C on platelet cytosolic free calcium concentration （ [ Ca^2 ＋ ] i）, platelet release reaction products beta-thromboglobulin（β-TG） and platelet factor 4（ PF4 ）were observed in dyslipoproteinemia patients with low HDL-C. Methods [ Ca^2 ＋ ] i, β-TG and PF4 were measured by fluorescent probe Fura 2- AM and ELISA skills respectively, in 42 patients with low HDL-C （LHDL-C） and 25 healthy controls （CONT）. Results Compared with those in CONT group,the platelet [ Ca^2 ＋ ] i, β-TG and PF4 were all higher in LHDL-C group （ all P 〈 0.01 ）. In LHDL-C group, the concentration of HDL-C was correlated negatively with platelet [ Ca^2 ＋ ] i,β-TG and PF4 （ all P 〈 0. 01 ）. Platelet [ Ca^2＋ ]i was also correlated with β-TG and PF4 positively in LHDL-C group（all P 〈0. 01 ）. The platelet [ Ca^2＋ ] i were positively correlated with β-TG and PF4 respectively in two groups（ all P 〈 0.01 ）. The ratio of beta-TG over PF4 was fluctuated. Conclusion These data suggest that low HDL-C induces platelet activation and release reaction by increasing concentration of cytosolic free calcium,which might be involved in pathogenesis of atherosclerosis and thromboembolism.

关 键 词：脂蛋白类 HDL胆固醇 血小板胞浆游离钙 Β-血小板球蛋白 血小板因子4 

分 类 号：R5[医药卫生—内科学]