| 闾佳佳 李倩 金英玉 于雪源 辛晓敏.微粒和血细胞在脓毒症高凝状态中的作用[J].,2014,14(26):5049-5053 |
| 微粒和血细胞在脓毒症高凝状态中的作用 |
| Role of the Microparticle (MP) and PS Exposure of Erythrocytes and Plateletsin the Procoagulant State of Sepsis |
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| DOI： |
| 中文关键词: 磷脂酰丝氨酸 微粒 脓毒症 凝血 |
| 英文关键词: Phosphatidylserine Microparticle Sepsis Coagulation |
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| 中文摘要: |
| 目的：探讨血小板和红细胞磷脂酰丝氨酸（PS）暴露和循环微粒（MPs）在脓毒症高凝状态中的作用。方法：集10 例诊断为脓毒症的患者及10 例健康体检者的新鲜血；离心分离出红细胞、富血小板血浆及MPs；应用Alexa-Fluro 488- 乳粘素/CD 41a/CD14、Alexa-Fluro 647-CD 235a/CD 31/CD 45 标定红细胞、血小板、内皮细胞、白细胞及单核细胞来源的MPs；流式细胞仪测定红细胞和血小板的PS 外翻、MPs的数量；血凝仪测定相应凝血时间。结果：相对于健康人，脓毒症患者PS 外翻红细胞（3.53%vs
0.53%，P<0.05）和血小板（3.00% vs 0.45%，P<0.05）、MPs 总数（4830/uL vs 2861/uL，P<0.05）及各亚型MPs 均明显升高；红细胞（238.4s vs 346.8s，P<0.05）、血小板（209.1s vs 335.9s，P<0.05）及MPs（207.1s vs 318.2s，P<0.05）的凝血时间缩短。MP 数、PS+ 红细胞/ 血小板比例分别与各自凝血时间成负相关（MP: r= -0.592，P=0.006；红细胞: r= -0.565，P=0.009；血小板：r= -0.641，P=0.002）。结论：红细胞、血小板的PS 暴露及循环MPs 和脓毒症高凝状态的发生相关，可能对患者凝血功能检测和抗凝治疗有一定的意义。 |
| 英文摘要: |
| Objective:To investigate the role of microparticle (MP) and phosphatidylserine (PS) exposure of erythrocytes and
platelets in the procoagulant state in sepsis.Methods:Peripheral blood samples were collected from 10 patients with newly diagnosed
sepsis and 10 matched healthy subjects. Erythrocytes, platelets, and MPs were obtained by centrifugation. Alexa-Fluro
488-lactadherin/CD 41a/CD 14 and Alexa-Fluro 647-CD 235a/CD 31/CD 45 were used to label MPs derived from platelets, monocytes,
erythrocytes, endothelial cells, and leukocytes. PS exposure of platelets and erythrocytes was detected with Alexa-Fluro 488-lactadherin.
Analysis of MP release and PS exposure on erythrocytes and platelets were performed with a flow cytometer. Procoagulant activity
(PCA) was determined by clotting time.Results:Compared with healthy subjects, patients with sepsis had markedly increased MP release
(4830/uLvs 2861/uL, P<0.05) and PS exposure on erythrocytes (3.53% vs 0.53%, P<0.05) and platelets (3.00% vs 0.45%, P<0.05).
Relevant PCA was significantly increased as determined by shortened clotting time (erythrocytes: 238.4s vs 346.8s, P<0.05; platelets:
209.1s vs 335.9s, P<0.05; MPs: 207.1s vs 318.2s, P<0.05). The level of circulating MPs, PS+ erythrocytes %, and PS+ platelets% was
negatively correlated with its own relevant clotting time (MP: r= -0.592, P=0.006；erythrocytes: r= -0.565, P=0.009；platelets: r= -0.641,
P=0.002).Conclusion:Increased MPs and PS+ erythrocytes/platelets are associated with the procoagulant state in patients with sepsis,
and may have clinical significance in evaluating and predicting the effect of anticoagulant therapy. |
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