Fusegawa Hisae, Shiraishi Koichi, Ogasawara Fusao, Shimizu Mie, Haruki Yasuo, Miyachi Hayato, Matsuzaki Shohei, Ando Yasuhiko
Department of Laboratory Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Tokai J Exp Clin Med. 2002 Dec;27(4):101-6.
To elucidate the mechanisms of thrombocytopenia in chronic hepatitis C (CHC), we investigated platelet activation in patients with chronic viral liver diseases.
Platelet activation was evaluated with flow cytometry in twenty-five patients with chronic viral hepatitis and 11 patients with liver cirrhosis of viral etiology. Liver biopsies were carried out in all patients.
The platelet counts decreased significantly in patients with CHC and in patients with liver cirrhosis compared to controls, but not in patients with chronic hepatitis B (CHB). Patients with CHC had a significantly higher percentage of platelets positive for activation-dependent monoclonal antibodies (MoAbs), and also had a higher percentage of platelet microparticles (PMP), a marker of platelet activation, than patients with CHB. There was a significant correlation between the percentage of PMP and the levels of liver fibrosis markers, such as serum hyaluronate and N-terminal propeptide of type III procollagen (P-III-P), in CHC, suggesting the relationship between platelet activation and liver fibrosis. Platelet activation was markedly enhanced in CHC patients with high histological scores of liver fibrosis.
Patients with CHC have increased platelet activation, which may contribute to the occurrence of thrombocytopenia in CHC. Liver fibrosis may play a role in activation of platelets in CHC.
为阐明慢性丙型肝炎（CHC）患者血小板减少的机制，我们对慢性病毒性肝病患者的血小板活化情况进行了研究。
采用流式细胞术对25例慢性病毒性肝炎患者和11例病毒性病因肝硬化患者的血小板活化情况进行评估。所有患者均进行了肝活检。
与对照组相比，CHC患者和肝硬化患者的血小板计数显著降低，但慢性乙型肝炎（CHB）患者的血小板计数未降低。与CHB患者相比，CHC患者中活化依赖性单克隆抗体（MoAbs）阳性的血小板百分比显著更高，且血小板微粒（PMP，血小板活化的标志物）百分比也更高。在CHC患者中，PMP百分比与肝纤维化标志物水平（如血清透明质酸和III型前胶原N端前肽（P-III-P））之间存在显著相关性，提示血小板活化与肝纤维化之间的关系。肝纤维化组织学评分高的CHC患者血小板活化明显增强。
CHC患者血小板活化增加，这可能导致CHC患者发生血小板减少。肝纤维化可能在CHC患者血小板活化中起作用。
