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目的:应用全血流式细胞术(FCM)结合血小板活化特异性单抗检测急性肺血栓栓塞症(PTE)患者血小板活化状态,探讨血小板活化在急性PTE中的作用及临床意义。方法:以凝血因子Ⅰ受体(FIB-R)、P-选择素(CD62P)作为分子标志物,利用FCM荧光标记法检测36例急性PTE患者和20例健康对照者微量全血FIB-R、CD62P血小板表面阳性表达的百分率,并比较急性PTE患者治疗前后FIB-R、CD62P在血小板表面阳性表达的变化。结果:急性PTE患者血小板表面活性标志蛋白FIB-R、CD62P阳性率分别为(18.30±12.23)%、(12.07±6.54)%,均显著高于对照组[(1.81±0.88)%、(2.18±1.50)%,(P<0.01)]。溶栓和抗凝治疗后各项指标均较治疗前明显下降(均P<0.01)。结论:急性PTE患者体内存在着明显的血小板活性增强,全血FCM能准确地反映体内血小板的活化水平。
Objective: To investigate the role of platelet activation in acute PTE and its clinical significance in patients with acute pulmonary thromboembolism (PTE) by using whole blood flow cytometry (FCM) combined with platelet activation specific monoclonal antibody. Methods: FIB-R and P-selectin (CD62P) were used as molecular markers to detect FIB-R in 36 patients with acute PTE and 20 healthy controls by FCM fluorescent labeling. CD62P positive rate of platelet surface, and compare the changes of positive expression of FIB-R and CD62P on platelet surface in patients with acute PTE before and after treatment. Results: The positive rates of FIB-R and CD62P on platelet in acute PTE patients were (18.30 ± 12.23)% and (12.07 ± 6.54)%, respectively, which were significantly higher than those in control group [(1.81 ± 0.88)% and 1.50)%, (P <0.01)]. Thrombolysis and anticoagulation after treatment were significantly decreased in all the indicators (all P <0.01). Conclusion: There is obvious increase of platelet activity in acute PTE patients. Whole blood FCM can accurately reflect the activation of platelet in vivo.