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目的 探讨脑梗死急性期血小板GMP - 140、血浆GMP - 140、血小板粘附率和聚集率的变化及意义。方法 对大灶脑梗死组 (n =2 2 )、小灶脑梗死组 (n =2 5 )和腔隙性脑梗死组 (n =2 0 )病人进行研究 ,于发病后 3d和 2周采静脉血 ,采用酶联免疫吸附竞争法测定血小板GMP - 140、酶联免疫吸附双抗体夹心法测定血浆GMP - 140的浓度。结果 发病 3d内大灶脑梗死组血小板GMP - 140、血浆GMP - 140浓度较对照组非常显著升高 (P <0 .0 0 1) ,小灶脑梗死组和腔隙性脑梗死组血小板GMP - 140、血浆GMP - 140浓度也较对照组升高 (P <0 .0 0 5～0 .0 0 1) ,但无大灶脑梗死组升高明显 (P <0 .0 5 ) ;小灶脑梗死组与腔隙性脑梗死组无显著性差异 (P >0 .0 5 ) ;3组病人血小板粘附率 (PAdT)和血小板聚集率 (PAgT)均显著升高 (P <0 .0 1)。发病 2周时 ,3组病人血小板GMP -140、血浆GMP - 140浓度均已明显下降 ,但仍较对照组高 (P <0 .0 5 ) ,而PAdT和PAgT均降至正常或更低。结论 不同类型脑梗死急性期血小板处于显著的活化状态 ,血浆GMP - 140浓度PAdT和PAgT能更准确地反映血小板的活化状态。
Objective To investigate the changes of platelet GMP - 140, plasma GMP - 140, platelet adhesion rate and aggregation rate in acute cerebral infarction and its significance. Methods The patients with focal cerebral infarction (n = 2 2), small cerebral infarction (n = 25) and lacunar infarction (n = 20) were studied. Venous blood was collected at 3d and 2 weeks after onset , Platelet GMP - 140 was detected by enzyme - linked immunosorbent assay, and plasma GMP - 140 concentration was measured by enzyme - linked immunosorbent assay (ELISA). Results The levels of GMP - 140 and GMP - 140 in platelet of cerebral infarction group were significantly higher than that of control group (P <0.01) on the 3rd day after onset of cerebral infarction. GMP - 140 level of platelet in cerebral infarction group and lacunar infarction group , Plasma GMP - 140 concentration was also higher than that of the control group (P <0.05-0.0001), but no significant increase in the group of focal cerebral infarction (P <0.05); small cerebral infarction group (P> 0.05). The platelet adhesion rate (PAdT) and platelet aggregation rate (PAgT) in three groups were significantly increased (P <0.01). At 2 weeks after onset, the platelet GMP - 140 and plasma GMP - 140 concentrations in all three groups were significantly decreased, but still higher than those in the control group (P <0.05), while both PAdT and PAgT decreased to normal or lower. Conclusion The platelets in different types of acute cerebral infarction are significantly activated. The plasma GMP - 140 concentrations of PAdT and PAgT can reflect the platelet activation more accurately.