抗血小板治疗对急性脑梗死患者血小板-白细胞聚集体的影响.docVIP

抗血小板治疗对急性脑梗死患者血小板-白细胞聚集体的影响 曹勇军 王引明 刘春风 苏州大学附属第二医院神经内科（215004） 【摘要】目的：观察急性脑梗死患者血小板-白细胞聚集体（PLA）的变化以及抗血小板治疗对其变化的影响，探讨PLA和血浆C－反应蛋白（CRP）、血小板聚集率的关系，寻找新的同时反映体内炎症和血小板活化水平的指标。方法 对46名脑梗死患者和24名年龄相配的对照者进行血小板白细胞聚集体（PLA）、CRP和血小板聚集率等指标的检测、比较。结果：对照组的血小板单核细胞聚集体（PMA）、血小板聚集率（ADP）和CRP分别为（6.62±1.81）%、（49.71±16.60）%和(1.66±2.00)mg/l, 脑梗死组的PMA、血小板聚集率和CRP分别为（12.40±2.15）%、（61.80±9.51）% 和（5.99±7.95）mg/l，均高于对照组，两组间有显著性差异；脑梗死组PLA、血小板中性粒细胞聚集体(PNA)和血小板淋巴细胞聚集体（PLyA）亦较对照组增高，但两组间无显著性差异。脑梗死组PMA与CRP和血小板聚集率（PAgT）正相关。脑梗死组应用阿司匹林和氯吡格雷治疗后，PMA、PAgT和CRP有明显下降(P＜0.01)。结论：脑梗死患者的PLA水平增高，其中PMA显著增高，PMA能够反应患者体内炎症和血小板活化水平。抗血小板治疗能够减少血小板活化。 【关键词】脑梗死；血小板白细胞聚集体；C－反应蛋白；血小板聚集率；抗血小板治疗 Effects of platelet–leukocyte aggregations with antiplatelet therapy in cerebral infarction patients CAO Yongjun, WANG Yinming，LIU Chunfeng (Department of Neurology, the Second Affiliated Hospital of Soochow University, , 215004，Suzhou，China ) 【Abstract】Objective:To investigate the changes of circulating leukocyte-platelet aggregations in cerebral infarction patients and effects with antiplatelet therapy. Methods: The number of circulating leukocyte-platelet aggregations was measured in both cerebral infarction group and the controls before and after antiplatelet therapy.Furthermore the changes of c-reaction protein and platelet aggregation rate etc. were determined and compared between both groups. Results:There was no significant difference in lymphocyte-platelet and neutrophil-platelet aggregate number in patients and controls; however, there was a significant difference in the percentage of monocyte-platelet aggregates between the patients and control group.The level of monocyte-platelet aggregates,serum C- reactin protein and platelet aggregation rate were higher in the case group than in the control group.The number of monocyte-platelet aggregates were positively related with the serum C- reactin protein and platelet aggregation rates.In cerebral infarction group,which were treated with Aspirin and Clopidogrel, PMA, PAg and CRP decrea