缺血性脑卒中患者阿司匹林抵抗与血小板膜糖蛋白CD62p CD63及GPⅡb Ⅲa的相关性研究

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目的:探讨缺血性脑卒中患者体内血小板膜糖蛋白CD62p、CD63及GPⅡb/Ⅲa的变化与阿司匹林抵抗的关系。方法:随机选取2009年1月至2010年12月期间我院缺血性脑卒中患者60例以及同期体检健康人30例,采用FCM测定人群体内CD62p、CD63及GPⅡb/Ⅲa表达的阳性率,60例缺血性脑卒中患者接受阿司匹林(100mg,qd)治疗2周后进行流式细胞学检测,根据血小板聚集率(PAG)将患者分为阿司匹林抵抗组(AR组)8例,和阿司匹林敏感组(AS组)52例,30例健康人作为对照组。再次测定三组人群体内CD62p、CD63及GPⅡb/Ⅲa表达的阳性率。结果:①60例缺血性脑卒中患者治疗后血小板CD62p、CD63及GPⅡb/Ⅲa表达的阳性率较治疗前明显降低,但高于对照组水平,数据间差异具有统计学意义(P<0.01)。②AR组患者血小板GPⅡb/Ⅲa表达阳性率高于AS组患者,数据见差异具有统计学意义(P<0.01)。结论:GPⅡb/Ⅲa可作为缺血性脑卒中患者阿司匹林治疗早期识别的参考指标。 Objective: To investigate the relationship between changes of platelet glycoproteins CD62p, CD63 and GPⅡb / Ⅲa and aspirin resistance in patients with ischemic stroke. Methods: Sixty patients with ischemic stroke in our hospital from January 2009 to December 2010 were randomly selected, and 30 healthy subjects were enrolled in this study. The positive rates of CD62p, CD63 and GPⅡb / Ⅲa expression in the population were determined by FCM. The patients with ischemic stroke were treated with aspirin (100 mg, qd) for 2 weeks and then were analyzed by flow cytometry. According to the platelet aggregation rate (PAG), 8 patients were divided into aspirin resistance group (AR group) and aspirin sensitive group (AS group) 52 cases, 30 healthy people as the control group. The positive rates of CD62p, CD63 and GPIIb / IIIa expression in three groups were determined again. Results: ① The positive rates of CD62p, CD63 and GPⅡb / Ⅲa expression in 60 ischemic stroke patients were significantly lower than those before treatment, but higher than those in control group. The difference was statistically significant (P <0.01). ② The positive rate of platelet GPⅡb / Ⅲa expression in AR group was higher than that in AS group, and the difference was statistically significant (P <0.01). Conclusion: GPⅡb / Ⅲa can be used as a reference index for early recognition of aspirin in patients with ischemic stroke.
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