急性脑梗死血小板活化状态的检测及临床意义  

The detection of the platelet activation status of the acute cerebral infarction and its clinical significance

作　　者：胡瑛 朱蓝玉[2] 张冬[3] 于增国[2] 

机构地区：[1]解放军第二一○医院检验科,辽宁大连116021 [2]大连大学医学院检验系,辽宁大连116622 [3]大连市中医医院检验科,辽宁大连116000

出　　处：《中国医药科学》2012年第12期108-110,共3页China Medicine And Pharmacy

摘　　要：目的探讨急性脑梗死发病不同时期中血小板的活化状态以及各项检测指标的相互关系与临床意义。方法采用FCM测定52例脑梗死患者发病的急性期(发病1～3d)和稳定期(治疗的10～14d)血小板CD62p和CD63表达率,用玻球法测定PAdT,智能血液凝集仪测定PAgT,同时检测正常对照组30例。结果脑梗死急性期CD62p和CD63表达率较稳定期及正常对照组显著上调(P<0.01);待病情稳定时两者表达均明显下降,但亦较正常对照组增高(P<0.01),且CD62p和CD63表达呈著正相关(r=0.788,P=0.003);PAdT和PAgT在脑梗死急性期亦较正常对照组显著升高(P<0.01),稳定期则降至正常水平。结论 CD62p、CD63的表达与PAdT、PAgT随脑梗死病情演变而变化,两者呈一致性,共同参与脑梗死发生、发展病理过程;CD62p、CD63表达比PAdT、PAgT能更加敏感而准确地反映出血小板活化状态,且具有较高的一致性,可作为ACI诊断、病情监测及判断预后的重要指标之一。Objective This article studies on the platelet activation status during the different phases of acute cerebral infarction and the relationship of indicators in various detections and tells us the clinic significance of the research. Methods Determining the expression level of the p-selectin（CD62P）and lysosome membrane protein（CD63）of platelet by FCM during the acute phase（1 - 3 d after the occurrence）and the stable phase（10 - 14 d of the treatment）of 52 cases of cerebral infarction,determining the PAdT by glass ball method, and determining the PagT by intelligent blood coagulation instrument and meanwhile detect 30 cases of normal control group. Results In the acute phase of cerebral infarction,the expression level of CD62p and CD63 was significantly higher（P 〈 0.01）than that of the stable phase and the normal control group.When the conditions of patients were stable,the expression level of CD62p and CD63 was significantly decreased but still higher than the normal control group（P 〈 0.01）,and the expression level of CD62p was obviously positively correlated with that of CD63（r=0.788, P=0.003）.In the acute phase of cerebral infarction,PAdT and PagT were both significantly increased than that of the normal control group,but they remrn to normal level when the illness comes to the stable phase. Conclusion CD62p and CD63,PAdT and PAgT change with the progression of cerebral infarction and show great correspondence,and they all involve in the occurrence and development process of pathogenesis of cerebral infarction. The expression level of CD62p and CD63 with higher consistent was more sensitive and accurate than PAdT and PAgT in reflecting the platelet activation status,it can he used as an important indicator for ACI diagnosis,observation of the disease course and prediction of the prognosis.

关 键 词：脑梗死 P-选择素 溶酶体蛋白 血小板粘附率 血小板聚集率 

分 类 号：R446.112[医药卫生—诊断学]