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医学论文范文:过敏性紫癜患儿GPⅡb/Ⅲa、P选择素及vWF检测的意义
【摘要】 目的 检测过敏性紫癜(HSP)患儿全血中血小板膜糖蛋白GPⅡb/Ⅲa(CD41a/CD61)、P选择素(CD62P)及血浆中血管性假血友病因子(vWF)的表达水平，探讨它们在HSP发病机制中的作用。方法 应用流式细胞仪和酶联免疫吸附试验(ELISA)分别检测HSP患儿(急性期44例，缓解期40例)及健康对照儿童(18例)空腹血CD41a/CD61、CD62P及vWF水平。结果 HSP患儿急性期CD41a/CD61、CD62P、vWF水平明显高于缓解期和对照组(P均<0.01);肾受累组CD41a/CD61、CD62P、vWF水平高于非肾受累组(P<0.01)。结论 血小板的活化及血管内皮的损伤在HSP的发病机制中起着重要作用，CD41a/CD61、CD62P、vWF水平的测定有助于了解HSP患儿早期的凝血异常，为抗凝治疗提供依据。
【关键词】 紫癜，过敏性;血小板膜糖蛋白类;P选择素;血管性假血友病因子;儿童
ZHANG Hongxia1, LIU Xuemei2, LIU Fange1, LIN Aiwei2， DUAN Chunhong2， YANG Xiaomei2
(1. Department of Pediatrics, Second Hospital of Shandong University, Jinan 250033, China;
2. Qilu Children′s Hospital of Shandong University， Jinan 250022, China)
To investigate the role of platelet membrane glycoproteinⅡb/Ⅲa, Pselectin and von Willebrane Factor in children with HenochSchonlein purpura (HSP), and to investigate the pathological role of them in HSP. Methods The concentrations of CD41a/CD61 and CD62P were determined by flow cytometry and the level of vWF by an enzymelinked immunosorbent assay(ELISA) method in 44 patients with acute HSP, 40 patients in the recovery phase and 18 healthy controls. Results The plasma levels of CD41a/CD61, CD62P and vWF in the acute phase were significantly higher than those in the recovery phase, were higher than those in healthy controls(P<0.01), and also were higher in the renal damage group than in the nonrenal damage group(P<0.01). Conclusion Activation of platelet and damage of vascular endothelium play important roles in the pathological mechanism of HSP. Levels of CD41a/CD61, CD62P and vWF are helpful in finding the disturbance of blood coagulation，and provide a basis for anticoagulant treatments医.学全.在.线网站www.lindalemus.com.
Key words: Purpura, HenochSchonlein; Platelet membrane glycoproteins; Pselectin; von Willebrane factor; Child 过敏性紫癜(henochschonlein purpura，HSP)是儿童最常见的血管炎之一。有文献报道[1]，约20～80%的HSP患儿并发肾脏损害，导致过敏性紫癜性肾炎(henochschonlein purpura nephritis, HSPN)。HSP的发病机制尚未完全明了，近年来许多研究[23]认为，HSP患儿血小板的聚集功能增强，存在血液的 高凝状态甚至有微血栓形成。血小板膜糖蛋白(platelet membrane glycoprotein，GP)Ⅱb/Ⅲa是血小板聚集的关键因素，在出血与凝血过程中起着重要作用。P选择素，即CD62P，具有介导活化血小板、血管内皮细胞与白细胞粘附的功能[4]，为血小板活化的特异性标志。GPⅡb/Ⅲa与P选择素在血循环中的变化反映了血液凝血状态的早期改变。血管性假血友病因子(von willebrane factor, vWF)是血管内皮细胞损伤的标记物，血管内皮细胞受损时可促进血小板的粘附、聚集。本研究旨在观察HSP患儿GPⅡb/Ⅲa(CD41a/CD61)、P选择素(CD62P)及vWF的变化，探讨HSP发生时凝血状态的改变、内皮细胞损害与肾脏损害的关系。
