血小板激活在急性主动脉夹层并发全身炎症反应中的作用  

The Role of Platelet Activation in the Acute Aortic Dissection-related Systemic Inflammatory Responses

作　　者：何谦[1] 古君[2] 秦超毅[2] 曹钰[1] 张洪伟[2] 肖正华[2] 许飞 张尔永[2] 胡佳[2] 

机构地区：[1]四川大学华西医院急诊科,成都610041 [2]四川大学华西医院心血管外科,成都610041 [3]成都市妇女儿童中心医院麻醉科

出　　处：《华西医学》2016年第6期1004-1007,共4页West China Medical Journal

基　　金：国家自然科学基金(81300155;8137041)~~

摘　　要：目的探讨在主动脉夹层(AD)并发全身炎症反应时,血小板是否激活以及与全身炎症反应的相关性。方法采用横断面研究,抽取符合纳入标准的2015年1月1日-6月30日间就诊于四川大学华西医院急诊科,并诊断为AD的34例患者入AD组。再根据年龄、性别,采用1∶1∶1匹配的方法,抽取源自四川大学华西医院健康体检中心同期健康体检的高血压患者和正常人分别入高血压组和正常组,每组各34例。检测3组患者血小板激活指标平均血小板体积(MPV)/血小板计数(PLT)、肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6水平。比较各指标在各组间的差异及各指标间的相关性。结果 AD组、高血压组和正常组TNF-α分别为(20.9±4.5)、(4.3±1.9)、(5.4±1.6)pg/m L,IL-6分别为(168.8±75.1)、(8.4±2.9)、(8.7±3.8)pg/m L,AD组TNF-α、IL-6均高于高血压组和正常组(P<0.05);AD组、高血压组和正常组血清MPV/PLT分别为0.106±0.035、0.049±0.010和0.054±0.019,AD组高于高血压组和正常组(P<0.05);AD组的MPV/PLT分别与TNF-α(r=0.516,P=0.002)和IL-6(r=0.633,P<0.001)之间呈正相关。结论 AD患者的血小板可被激活,其激活程度和炎症反应之间存在相关性。Objective To explore whether platelet activation is associated with systemic inflammatory responses. Methods We conducted a cross-sectional study to enroll all aortic dissection （AD） patients （AD group） from January 1, 2015 to June 30, 2015 in the Emergency Department. According to the characteristics of AD patients, we matched hypertension （hypertension group） and health participants （health group） with AD patients at a proportion of 1：1：1. Blood samples were collected on admission for blood routine test [mean platelet volume （MPV）/ platelet （PLT）] and inflammatory cytokines [tumor necrosis factor （TNF）-a and interleukin （IL）-6] analysis. We compared all parameters among the three groups and performed bivariate correlation analyses. Results Expressions of TNF-a and IL-6 in the AD group [（20.9±4.5）, （168.8±75.1） pg/mL] were significantly higher than those in the hypertension group [（4.3±1.9）, （8.4±2.9） pg/mL] and healthy group [（5.4±1.6）, （8.7±3.8） pg/mL] （P 〈 0.05）. MPWPLT in the AD group was significantly higher than that in the hypertension group and healthy group （0.106±0.035 vs 0.049±0.010, P〈 0.05; 0.106±0.035 vs 0.054±0.019, P〈0.05）. There were positive correlations between MPV/PLT and TNF-α （r=0.516, P=0.002）, and between MPV/PLT and IL-6 （r=0.633, P 〈 0.001） in the AD group. Conclusion In summary, our study shows that platelets of AD patients can be activated, and the degree of activation is associated with systemic inflammatory responses.

关 键 词：主动脉夹层 血小板激活 全身炎症反应 肿瘤坏死因子-Α 白细胞介素-6 

分 类 号：R543.1[医药卫生—心血管疾病]