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目的 :探讨蝙蝠葛碱对二尖瓣狭窄 (mitralstenosis,MS)患者血小板不可逆聚集的影响。方法 :用流式细胞仪测定MS患者 (1 6例 )动脉血静息状态及凝血酶 (0 0 5U/ml、0 1U/ml、0 5U/ml、1 0U/ml)激活时 ,血小板膜表面糖蛋白Ⅳ (GPⅣ )及凝血酶敏感蛋白(TSP)分布状况 ,并与健康人 (1 4名 )比较。结果 :静息状态时MS患者血小板膜表面GPⅣ分布显著高于健康人 (P <0 0 1 ) ,而血小板膜表面TSP分布与健康人无显著性差异 (P >0 0 5 ) ,激活状态时MS患者血小板膜表面GPⅣ、TSP分布明显高于健康人 (P <0 0 5 ,P <0 0 1 ) ;蝙蝠葛碱 (5 0 μmol/L)可显著抑制凝血酶诱导的血小板膜GPⅣ再分布 (P <0 0 5 ,P <0 0 1 ) ,仅抑制较低浓度 (0 0 5U/ml,0 1U/ml)凝血酶诱导的血小板内TSP释放 (P <0 0 5 ,P <0 .0 1 ) ,而对较高浓度 (0 5U/ml,1 0U/ml)凝血酶诱导的TSP释放无抑制作用。结论 :MS患者动脉血血小板活性及对凝血酶的反应性增高 ,蝙蝠葛碱可降低MS患者血小板不可逆聚集的危险性。
Objective: To investigate the effect of dauricine on irreversible aggregation of platelets in patients with mitral stenosis (MS). METHODS: Flow cytometry was used to determine the resting state of arterial blood in patients with MS (16 cases) and platelet membrane activation at the activation of thrombin (0 0 5 U/ml, 0 1 U/ml, 0 5 U/ml, 10 U/ml). The distribution of surface glycoprotein IV (GPIV) and thrombospondin-sensitive protein (TSP) was compared with that of healthy individuals (14). RESULTS: The distribution of GPIV on platelet membrane surface was significantly higher in patients with MS than in healthy subjects (P < 0.01). The distribution of TSP on the platelet membrane surface was not significantly different from that in healthy individuals (P > 0.05). The distribution of GPIV and TSP on the platelet surface of MS patients was significantly higher than that of healthy subjects (P < 0.05, P <0.01). Daugiline (50 μmol/L) significantly inhibited the thrombin-induced platelet membrane GPIV redistribution. (P <0 0 5, P <0 0 1) only inhibited thrombin-induced TSP release from platelets at lower concentrations (0 0 5 U/ml, 0 1 U/ml) (P <0 0 5, P <0. 0 1 ), but no inhibitory effect on thrombin-induced TSP release at higher concentrations (0 5 U/ml, 10 U/ml). Conclusion : The platelet activity of arterial blood and the reactivity to thrombin are increased in patients with MS. Dosage of dauricine can reduce the risk of irreversible aggregation of platelets in MS patients.