关于2P和假血友病因子vWF在下肢缺血再灌注过程中的应用价值.doc

血小板膜糖蛋白CD62P和假血友病因子（vWF）在下肢缺血再灌注过程中的应用价值 马平，张宏江 （猪还是第二人民医院麻醉科，广东 珠海 519020） [摘要] 目的 探讨大鼠下肢缺血再灌注过程中血小板活化和内皮细胞功能的变化及其临床意义。方法 18只雄性SD大鼠随机分为假手术组（N）、下肢缺血两小时组(I2)及下肢缺血两小时再灌注三小时组(I2R3)。夹闭大鼠双侧股动脉，建立急性下肢缺血再灌注大鼠模型。观察急性下肢缺血再灌注大鼠的血小板膜糖蛋白CD62P和假血友病因子vWF在缺血及再灌注后表达的变化。结果 I2R3组大鼠血小板膜糖蛋白CD62P和vWF表达均高于N组，差异具有统计学意义(P0.05)；I2组vWF的表达高于N组，差异具有统计学意义（P0.05），而CD62P的表达与N组相近，差异没有统计学意义（P0.05）。结论 急性下肢缺血再灌注可以导致血小板活性增强和内皮细胞功能异常，检测CD62P及vWF可能有助于预测缺血再灌注损伤引起的血液系统的高凝状态。 [关键词] 急性下肢缺血再灌注 CD62P vWF 血栓形成 The application of the platelet membrane glycoprote in CD62P and vWF in rats after acute ischemia-reperfusion of hind limb 　　 MA Ping ，ZHANG Hongjiang.The second people’s hospital of zhuhai ，guangdong zhuhai 519020，China 【Abstract】　Objective　To investigate the changes of the platelet activation and endothelial cell disturbance after acute ischemia and reperfusion of hind limb. Methods　The eighteen rats were randomly divided into 3 groups: the sham operation group(N group);the ischemia 2h group(I2);the hind limb ischemia 2h and reperfusion 3h group ( I2R3 group ) ;and. An animal model of acute hind limb ischemia and reperfusion was developed by clamping femoral artery of rats. Changes in the expression of CD62P of platelet membrane and vWF in rats were observed following ischemia and reperfusion. Results 　The expression of CD62P of platelet membrane and vWF in the I2R3 group was significantly higher than that of the sham operation group (P 0.05) ,while the expression of vWF in I2 group was significantly higher than that of the sham operation group(P 0.05). There were no significant changes in the exp ression of CD62P among the IR group and the sham operation group. Conclusions　Acute hind limb ischemia and reperfusion can increase the platelet activation and endothelial cell disturbance in rats. 【Key words】 Acute hind limb ischemia and reperfusion CD62P vWF 围手术麻醉期,因止血带的使用而导致患者在术中或术后出现血栓栓塞性疾病的临床现象时有发生,特别是在骨科关节置换手术中，深静脉血栓形成的发生率达45％－70％，约3％可引起致命的肺梗死[1]，其机制尚不明确。血栓形成