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本研究观察了原发性血小板增多症(primary thrombocytosis,PT)患者临床血栓发生率及其与血小板功能变化的关系,探讨PT患者预防性应用血栓素A2抑制剂对其血小板活性的影响及其对血栓的预防和治疗的临床效果。以流式细胞术测定血小板表面的CD62P、PAC-1水平;ELISA方法测定血浆血栓素A2(TXA2)代谢产物TXB2和前列环素(PGI2)代谢产物6-K-PGF1α水平;观察和比较各组血小板功能的变化及其与血栓形成的关系。结果表明:奥扎格雷钠干预治疗前合并血栓组TXB2、CD62P、TXB2/6-keto-PGF1α比值均比未合并血栓组高,统计学差异具有显著性(p<0.01);奥扎格雷钠干预治疗后2组各项血小板功能指标除6-keto-PGF1α外,均较治疗前有明显降低(p<0.01),且合并血栓组在奥扎格雷钠治疗后除CD62P仍较未合并血栓组高(p<0.05)以外,其余指标均与未合并血栓组无显著性差异(p>0.05)。结论:PT合并血栓者血小板多项功能指标均较未合并血栓者异常升高,血小板功能活化也是PT患者血栓发生的高危因素。奥扎格雷钠均可使2组患者血小板活化指标明显降低,体内TXA2的生成减少和TXA2/PGI2的比值改善。奥扎格雷钠不但具有治疗血栓作用,而且还有较好的预防血栓效果。
This study observed the incidence of thrombosis in patients with primary thrombocytosis (PT) and its relationship with changes in platelet function, to explore the prophylactic use of thromboxane A2 inhibitors in patients with platelet activity and its effect on Thrombus prevention and treatment of clinical effects. The levels of CD62P and PAC-1 on platelets were measured by flow cytometry. The levels of TXB2 and PGI2 metabolites 6-K-PGF1α in plasma were measured by ELISA. Changes of platelet function and its relationship with thrombosis. The results showed that the ratio of TXB2, CD62P and TXB2 / 6-keto-PGF1α in patients with preoperative ozagrel combined with thrombolysis was significantly higher than those without thrombosis (p <0.01) After treatment, all the platelet function indexes of 2 groups were significantly lower than those before 6-keto-PGF1α treatment (p <0.01), and the levels of CD62P in patients with thrombolysis after ozagrel treatment were still higher than those without thrombosis (p <0.05), the other indicators were not significantly different from those in the non-combined thrombosis group (p> 0.05). Conclusion: The multi-function indexes of platelets in patients with PT complicated with thrombosis are abnormally elevated compared with those without thrombosis, and platelet activation is also a risk factor for thrombosis in patients with PT. Ozagrel sodium significantly reduced platelet activation, decreased TXA2 production and improved TXA2 / PGI2 ratio in both groups. Ozagrel sodium not only has the role of treatment of thrombosis, but also better prevention of thrombosis.