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目的 探讨脑梗死急性期血小板超微结构的变化及其意义。方法 采用透射电镜对 2 0例脑梗死急性期患者的血小板进行观察。结果 发病后 2 4小时内的血小板超微结构改变明显 ,表现为伪足增多 ,聚集融合成片状 ;α颗粒明显减少 ;线粒体也显著减少 ,残留者肿胀、空泡化 ;血小板膜多处破裂。血小板病变的严重程度与脑梗死病灶的大小相一致。发病后 2周血小板超微结构明显恢复 ,但 3例大面积脑梗死者未见恢复。结论 脑梗死急性期血小板超微结构发生明显改变 ,尤其是 α颗粒明显减少 ,可作为判断病情轻重及预后的一个客观指标。
Objective To investigate the changes of platelet ultrastructure in patients with acute cerebral infarction and its significance. Methods The platelets of 20 patients with acute cerebral infarction were observed by transmission electron microscopy. Results Within 24 hours after onset, the changes of platelet ultrastructure were obvious, with the increase of pseudopodia, aggregation and fusion into flake; α-granule was significantly reduced; mitochondria also decreased significantly, the remaining were swollen and vacuolized; . The severity of platelet disease is consistent with the size of the infarct. The ultrastructural changes of platelets recovered 2 weeks after onset, but no recovery was found in 3 cases of large area cerebral infarction. Conclusions The ultrastructural changes of platelets in acute stage of cerebral infarction are obviously changed, especially the α-granule is obviously reduced, which can be used as an objective index to judge the severity and prognosis of patients.