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目的:探讨大脑中动脉(MCA)狭窄致血小板活化机制及其与动脉粥样硬化性脑梗死的关系。方法:采用超高磁场(3.0T)MRA和流式细胞仪分别测定78例脑梗死患者大脑中动脉和周围血血小板表面糖蛋白CD62_p、Ⅱ_b-Ⅲ_a表达,并与45例非脑梗死头晕患者对比。结果:78例脑梗死患者见MCA狭窄71例(91.03%),其中轻度MCA狭窄24例,中度MCA狭窄27例,高度MCA狭窄20例;其相应CD62p、Ⅱ_b-Ⅲ_a表达阳性率分别达(4.07±2.99)%、(1.33±0.64)%:(4.96±4.54)%、(2.20±0.87)%和(6.01±4.34)%、(2.31±1.06)%,高度MCA狭窄者活化血小板明显高于正常者和轻度狭窄者(P<0.05)。结论:MCA动脉狭窄引起血管剪切力重构,导致血小板活化,是动脉粥样硬化性脑梗死血栓形成的重要机制。
Objective: To investigate the mechanism of platelet activation induced by stenosis of middle cerebral artery (MCA) and its relationship with atherothrombotic cerebral infarction. Methods: Ultra-high magnetic field (3.0T) MRA and flow cytometry were used to detect the expressions of CD62_p and Ⅱ_b-Ⅲ_a on platelet surface of middle cerebral artery and peripheral blood in 78 patients with cerebral infarction. Compared with 45 non-cerebral infarction patients with dizziness . Results: Seventy-seven patients (91.03%) with MCA stenosis were found in 78 patients with cerebral infarction, including 24 with mild MCA stenosis, 27 with moderate MCA stenosis and 20 with MCA stenosis. The positive rates of CD62p and Ⅱ_b-Ⅲa were (4.07 ± 2.99)%, (1.33 ± 0.64)% :( 4.96 ± 4.54)%, (2.20 ± 0.87)% and (6.01 ± 4.34)%, (2.31 ± 1.06)%, respectively In normal and mild stenosis (P <0.05). Conclusion: MCA artery stenosis caused by vascular shear remodeling, leading to platelet activation, is an important mechanism of atherothrombotic cerebral infarction.