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目的 通过观察血小板膜糖蛋白的动态变化了解川崎病患儿血小板活化及其活化程度。方法 用流式细胞术结合多种抗血小板膜糖蛋白单克隆抗体 (单抗 ) ,测定 2 0例川崎病患儿发病1周 (治疗前 )、2周、3周、4周时血小板膜CD4 1、CD4 2a、CD61、CD62p、CD63 的表达及阿司匹林、大剂量静脉注射丙种球蛋白 (IVIG ,1～ 2g/kg)对其表达的影响 ,观察活化血小板膜CD62p与冠状动脉损伤形成之间的关系。结果 川崎病患儿发病 4周内血小板膜糖蛋白CD4 1、CD4 2a、CD61、CD62p、CD63 的表达量高于正常对照组 (P <0 .0 5 ) ,阿司匹林、大剂量IVIG不能抑制川崎病患儿血小板膜上活化糖蛋白的高表达 ;有冠状动脉损伤的川崎病患儿活化血小板膜糖蛋白CD62p的表达量明显高于无冠状动脉损伤的川崎病患儿。结论 川崎病患儿血小板高度活化 ,血液呈高凝状态 ,血小板活化是川崎病病理生理的重要表现 ;活化血小板膜糖蛋白CD62p的明显增高可以作为川崎病患儿冠状动脉损伤的指标之一。
Objective To observe the platelet activation and its activation in children with Kawasaki disease by observing the dynamic changes of platelet membrane glycoprotein. Methods Flow cytometry combined with a variety of anti-platelet glycoprotein monoclonal antibody (monoclonal antibody), 20 cases of children with Kawasaki disease onset of 1 week (before treatment), 2 weeks, 3 weeks, 4 weeks platelet membrane CD4 1, CD4 (superscript 2a), CD61 (superscript +), CD62p (superscript +) and CD63 in serum and the effect of aspirin and high dose intravenous gamma globulin (IVIG) on the expression of CD62p and coronary artery injury relationship. Results The expression of platelet membrane glycoprotein CD4 1, CD4 2a, CD61, CD62p and CD63 in children with Kawasaki disease was significantly higher than that in the normal control group (P <0.05) within 4 weeks. Aspirin and high dose IVIG did not inhibit Kawasaki disease Children with platelet membrane activation glycoprotein expression; children with coronary artery injury Kawasaki disease activated platelet membrane glycoprotein CD62p expression was significantly higher than those without Kawasaki disease in children with coronary artery lesions. Conclusion Platelet activation in Kawasaki disease patients is highly hypercoagulable, and platelet activation is an important manifestation of Kawasaki disease. The marked increase of activated platelet membrane glycoprotein CD62p may be one of the indicators of coronary artery injury in children with Kawasaki disease.