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目的探讨老年慢性肺心病急性加重期患者血小板活化分子标记物膜糖蛋白PAC-1、GMP-140的变化及其与PH(肺动脉高压)的关系。方法用三色全血流式细胞术测定42例老年慢性肺心病急性加重期患者及42例缓解期患者外周血中血小板PAC-1、GMP-140的表达水平,并与30例老年健康对照者及30例非老年健康对照者比较。用超声心动图检测慢性肺心病患者肺动脉收缩压。结果老年慢性肺心病急性加重期组PAC-1、GMP-140的表达均明显高于缓解期组、老年健康对照组及非老年健康对照组(均P<0.001),并与肺动脉收缩压呈正相关。老年缓解期组PAC-1、GMP-140阳性表达率高于老年健康对照组(P<0.05)及非老年健康对照组(均P<0.001),老年健康对照组PAC-1、GMP-140阳性表达率亦高于非老年健康对照组(P<0.05)。老年慢性肺心病急性加重期组患者PAC-1的变化与GMP-140之间有显著的正相关(r=0.77;P<0.001)。结论老年慢性肺心病急性加重期患者血小板明显活化,其活化程度与PH关系密切。
Objective To investigate the changes of platelet-activated molecular marker glycoproteins PAC-1 and GMP-140 in elderly patients with acute exacerbation of chronic pulmonary heart disease and their relationship with PH (pulmonary hypertension). Methods The levels of platelet PAC-1 and GMP-140 in peripheral blood of 42 elderly patients with chronic cor pulmonale and 42 patients with remission were measured by using three-color whole blood flow cytometry and compared with 30 elderly healthy controls And 30 non-elderly healthy controls. Pulmonary Artery Systolic Pressure in Patients with Chronic Pulmonary Heart Disease by Echocardiography. Results The expression of PAC-1 and GMP-140 in elderly patients with acute exacerbation of chronic pulmonary heart disease were significantly higher than those in remission, elderly healthy controls and non-elderly healthy controls (all P <0.001), and were positively correlated with pulmonary arterial systolic pressure . The positive expression rates of PAC-1 and GMP-140 in elderly remission group were higher than those in healthy control group (P <0.05) and non-elderly healthy control group (all P <0.001) The expression rate was also higher than non-elderly healthy control group (P <0.05). There was a significant positive correlation between the changes of PAC-1 and GMP-140 in elderly patients with acute exacerbation of chronic pulmonary heart disease (r = 0.77; P <0.001). Conclusion Platelet activation is significantly activated in elderly patients with acute exacerbation of chronic pulmonary heart disease, and its activation is closely related to PH.