摘要
目的 研究慢性心房颤动 (房颤 )患者血栓形成与血浆腺苷水平、血小板活化的关系。方法 应用反相高效液相色谱及流式细胞仪 ,分析窦性心律及房颤患者血浆腺苷水平、血小板P选择素、GPⅡb/Ⅲa表达量 ,同时放免法测定血浆TXB2 、6 keto PGF1α含量 ,计算TXB2 / 6 keto PGF1α。并应用不同浓度的 8 苯基茶碱阻断腺苷受体 ,流式细胞仪分析其对血小板P选择素表达量的影响。结果 房颤组血浆腺苷水平明显低于窦性心律组 ,分别为 (5 5 6± 2 7 3) μg/L与 (77 5± 30 2 ) μg/L ,(P <0 0 1)。血小板P选择素表达量明显高于窦性心律组 ,分别为 (6 5 3± 3 37) %与 (4 72± 1 97) % ,P <0 0 5。血小板GPⅡb/Ⅲa有增高趋势 ,但无统计学意义 (18 7± 8 6 ) %与 (15 6± 8 3) % ,P >0 0 5。血浆TXB2 及TXB2 / 6 keto PGF1α含量均显著增高 [(15 0 3± 5 8 0 )ng/L与 (10 2 4± 36 5 )ng/L ,P <0 0 1;1 43± 0 5 9与 0 74± 0 2 9,P <0 0 0 1];而血浆 6 keto PGF1α的含量无显著变化 (P >0 0 5 )。血小板P选择素表达量房颤血栓形成组明显高于窦性心律无血栓组 [(7 34± 2 74) %与 (4 72± 1 97) % ,P <0 0 1];房颤血栓形成组与房颤无血栓组无显著差异 [(7 34± 2 74) %与 (6 17± 2 76 ) %
Objective To study the relationship among thromboembolism, plasma levels of adenosine and platelet activation in patients with atrial fibrillation (Af) and patients with sinus rhythm (SR). Methods Using high performance liquid chromatography and flow cytometry technique, the plasma level of adenosine, the expression of platelet CD62P and platelet GP Ⅱb/Ⅲa in 31 patients with Af and 22 patients with SR were studied. Plasma levels of TXB 2 and 6 keto PGF1α were analyzed by radioimmunoassay, and TXB 2/6 keto PGF1α were calculated. The effect of 8 sulfophenyltheophylline, an antagonist of adenosine receptor, on platelet CD62P expression was studied by flow cytometry. Results Plasma levels of adenosine were lower in patients with Af than in controls (55 6±27 3) μg/L vs (77 5±30 2) μg/L (P<0 01). The expression of platelet CD62P was higher in patients with Af than that with SR (6 53±3 37)% vs (4 72±1 97)% (P< 0 05), and significant difference was found between Af with thromboembolism and SR without thromboembolism (7 34±2 74)% vs (4 72±1 97)% (P< 0 01), as well as in Af without thromboembolism and SR without thromboembolism (6 17± 2 76)% vs (4 72±1 97)% (P< 0 05). No difference was observed between Af with thromboembolism and Af without thromboembolism (7 34±2 74)%vs (6 17±2 76)% (P> 0 05). There was an increased trend of platelet GP Ⅱb/Ⅲa in patients with Af, but without statistical significance (18 7±8 6)% vs (15 6±8 3)% (P> 0 05). The plasma levels of TXB 2 and TXB 2/6 keto PGF1α were also higher in patients with Af than those with SR (150 3±58 0) ng/L vs(102 4±36 5) ng/L (P< 0 01), (1 43±0 59) vs (0 74± 0 29) (P< 0 001) respectively. The plasma levels of 6 keto PGF1α decreased in patients with Af, but there was no statistical significance (116 6±53 2) ng/L vs (148 5±48 4) ng/L (P> 0 05). The antagonism of adenosine receptors with 8 sulfophenyltheophylline increased the expression of CD62P on platelets in vitro. Within certain limits, there was a dose dependent manner. When the concentration of 8 sulfophenyltheophylline increasedhigher than 10 -3 mol/L, the expression of platelet CD62P decreased instead. ConclusionThe decreaseof plasma adenosine levels may be one of the causes of platelets activation and thromboembolism in patients with Af. Adenosine and adenosine regulating agents, such as acadesine, may prevent thromboembolism in these patients.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2000年第5期367-370,共4页
Chinese Journal of Cardiology
关键词
心房颤动
血栓形成
腺苷
P选择素
Atrial fibrillation
Thrombosis
Adenosine
P Selectin
