慢性阻塞性肺疾病急性加重期患者血小板活化与中性粒细胞凋亡的相关性研究  

Relationship between blood platelet activation and neutrophil apoptosis in patients with acute exacerbations of chronic obstructive pulmonary disease

作　　者：徐芝君[1] 许国根[1] 徐远胜[1] 顾清[1] 

机构地区：[1]杭州市第一人民医院急诊科,浙江杭州310006

出　　处：《中国急救医学》2013年第12期1110-1113,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的观察慢性阻塞性肺疾病急性加重期（AECOPD）患者血小板活化和中性粒细胞（PMN）凋亡的发生情况，并探讨其相关性及临床意义。方法对38例符合AECOPD诊断标准的患者采用流式细胞技术检测血浆中的血小板糖蛋白P一选择素／血小板质膜蛋白（CD62P／CD61）；分离纯化痰液中PMN，应用流式细胞技术测定PMN凋亡、坏死、存活细胞比例及呼吸爆发功能的变化，设健康对照组。结果AECOPD患者血浆中CD62P／CD61较健康对照组显著升高（P〈0．01），痰液中PMN凋亡比例显著降低（P〈0．01），而PMN呼吸爆发显著升高（P〈0．01），CD62P／CI）61与PMN凋亡、坏死及呼吸爆发有显著的相关性（P〈0．05，P〈0．01）。结论AECOPD患者存在血小板活化，与PMN在气管和肺组织中大量扣押，凋亡途径发生障碍，持续处于激活状态及炎症毒性物质的持续释放并存，PMN凋亡、坏死、存活细胞比例及呼吸爆发功能的变化和PMN在气管和肺组织中持续活化并释放炎症毒性物质与血小板活化有关。Objective To observe the relationship with platelet activation and polymorphonuclear leukocyte （PMN） apoptosis in patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD）, and to explore their correlation and clinical significance. Methods 38 cases were enrolled with the diagnosis of AECOPD. Flow cytometry was used to detect plasma platelet glycoprotein, P - select element/platelet membrane protein （ CD62P/CD61 ）. After the PMNs were purified and separated from phlegm liquid, flow cytometry technology was applied to determine PMN apoptosis, necrosis, cell survival ratio and respiratory organ function. Healthy controls were also established. Results Compared to healthy control, patients with AECOPD showed significantly increased plasma CD62P/CD61 level （P 〈 0.01 ）, significantly decreased sputum PMN apoptosis ratio （ P 〈 0.01 ）, significantly increased respiratory organ of PMN （ P 〈 0.01 ）, and a significant correlation between CD62P/CD61 and PMN apoptosis, necrosis and respiratory organ （ P 〈 0. 05, P 〈 0. 01 ）. Conclusion Platelet activation exists in AECOPD patients, which correlates to the accumulation of PMNs in the trachea and lung tissue. The disorder of PMN apoptosis pathway subsequently causes a sustained active inflammation and release of toxic substance. PMN apoptosis, necrosis, cell survival ratio and respiratory organ function changes and sustained activation of PMN in trachea and lung tissue, inflammation and releasing toxic substances also associated with platelet activation.

关 键 词：慢性阻塞性肺疾病急性加重期(AECOPD) 血小板活化 中性粒细胞 凋亡 

分 类 号：R563[医药卫生—呼吸系统]