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目的探讨血浆血小板α－颗粒膜蛋白（ＧＭＰ－１４０）及血管性假血友病因子（ｖＷＦ）在肝硬化患者血中变化的临床及病理生理意义。方法采用双抗体夹心固相酶免疫试验方法分别定量测定４０例肝硬化患者与３１例对照者血浆ＧＭＰ－１４０及ｖＷＦ水平。结果发现肝硬化患者血浆ＧＭＰ－１４０、ｖＷＦ水平比对照组有非常显著的增高（Ｐ＜００１），且发现肝硬化患者ＣｈｉｌｄＢ、Ｃ级均较ＣｈｉｌｄＡ级的ＧＭＰ－１４０水平显著升高（Ｐ＜００１），有上消化道出血组比无出血组的血浆ＧＭＰ－１４０、ｖＷＦ水平亦明显增高（Ｐ＜００５），同时还发现肝硬化组血浆ＧＭＰ－１４０、ｖＷＦ水平与血小板计数之间的关系均不相关（ｒ分别为－００３４９及－０１６２１，Ｐ＞００５）。结论肝硬化患者血浆ＧＭＰ－１４０、ｖＷＦ的升高可作为体内血小板活化与肝脏血管内皮细胞损伤的指标，可用来反映肝损伤状况及上消化道出血倾向。
Objective To investigate the clinical and pathophysiological significance of plasma platelet α-granule membrane protein (GMP-140) and von Willebrand factor (vWF) in the blood of cirrhotic patients. Methods The levels of plasma GMP-140 and vWF in 40 patients with cirrhosis and 31 controls were measured by double antibody sandwich enzyme immunoassay. The results showed that the plasma levels of GMP-140 and vWF in patients with cirrhosis were significantly higher than those in the control group (P <001), and the levels of ChildB and C in patients with cirrhosis were significantly higher than that of ChildA-GMP-140 P <001). The levels of plasma GMP-140 and vWF in patients with upper gastrointestinal bleeding were significantly higher than those without bleeding (P <005). The levels of plasma GMP-140 and vWF in patients with cirrhosis There was no correlation between platelet counts (r = -0.0349 and -0.1621, P> 0.05). Conclusions The elevation of plasma GMP-140 and vWF in patients with cirrhosis can be used as an indicator of platelet activation and hepatic vascular endothelial cell injury in vivo, which can be used to reflect the status of liver injury and the tendency of upper gastrointestinal bleeding.