Gosk-Bierska I, Adamiec R, Szuba A
Department and Clinic of Angiology, Hypertension and Diabetology, Wroclaw Medical University Wroclaw, Poland.
Int Angiol. 2003 Jun;22(2):164-71.
Platelet thrombi play critical role in pathogenesis of cardiovascular complications in atherosclerotic peripheral arterial disease (PAOD). The aim of this study was to evaluate the concentration of platelets GP IIb/IIIa, GP I b/IX and plasma levels of their ligands (fibrinogen and vWF) and their relation to other atherosclerotic risk factors in the patients with intermittent claudication secondary to PAOD.
Consecutive patients of the University Vascular Clinic were studied: 64 claudicants and 38 controls were enrolled. The concentration of platelets GPII b/IIIa and GP Ib/IX was estimated by ELISA method using monoclonal antibody against GPII b/IIIa (CD41a) and GPI b/IX (CD42a Immunotech). Plasma levels of vWF, fibrinogen, and platelets were measured by routine
Plasma vWF (145+/-41%), fibrinogen (3.8+/-1 g/l) and platelet concentration of GP Ib/IX (121.1+/-23.39), GPIIb/IIIa (117.9 6 +/-32.7%), as well as plasma lipids and uric acid were statistically higher in claudicants than in controls (vWF: 103+/-42%, fibrinogen: 2.9+/-0.5 g/l, GP Ib/IX: 100+/-16.9%, GP IIb/IIIa: 100+/-29.4%). We have observed statistically higher concentration of GP IIb/IIIa and GP Ib/IX in smoking patients than in non-smoking patients with PAOD and significant correlation between the concentration of GP Ib/IX and GP IIb/IIIa and plasma fibrinogen in patients with PAOD and controls.
Our results demonstrate higher platelet concentration of GP Ib/IX,GP IIb/IIIa and elevated plasma levels of ligands for platelets receptors-fibrinogen and vWF in patients with PAOD. This prothrombotic conditions may explain increased cardiovascular morbidity and mortality in this patient's group.
血小板血栓在动脉粥样硬化性外周动脉疾病(PAOD)的心血管并发症发病机制中起关键作用。本研究旨在评估PAOD继发间歇性跛行患者血小板糖蛋白IIb/IIIa、糖蛋白Ib/IX的浓度及其配体(纤维蛋白原和血管性血友病因子)的血浆水平,以及它们与其他动脉粥样硬化危险因素的关系。
对大学血管诊所的连续患者进行研究:纳入64例跛行患者和38例对照。采用抗糖蛋白IIb/IIIa(CD41a)和糖蛋白Ib/IX(CD42a Immunotech)的单克隆抗体,通过ELISA法测定血小板糖蛋白IIb/IIIa和糖蛋白Ib/IX的浓度。通过常规方法测量血浆血管性血友病因子、纤维蛋白原和血小板水平。
与对照组相比,跛行患者的血浆血管性血友病因子(145±41%)、纤维蛋白原(3.8±1 g/l)、血小板糖蛋白Ib/IX浓度(121.1±23.39)、糖蛋白IIb/IIIa浓度(117.96±32.7%)以及血浆脂质和尿酸在统计学上显著更高(血管性血友病因子:103±42%,纤维蛋白原:2.9±0.5 g/l,糖蛋白Ib/IX:100±16.9%,糖蛋白IIb/IIIa:100±29.4%)。我们观察到,PAOD吸烟患者的糖蛋白IIb/IIIa和糖蛋白Ib/IX浓度在统计学上高于非吸烟患者,且PAOD患者及对照组中糖蛋白Ib/IX和糖蛋白IIb/IIIa的浓度与血浆纤维蛋白原之间存在显著相关性。
我们的结果表明,PAOD患者血小板糖蛋白Ib/IX、糖蛋白IIb/IIIa浓度较高,血小板受体配体纤维蛋白原和血管性血友病因子的血浆水平升高。这种促血栓形成状态可能解释了该患者群体心血管发病率和死亡率的增加。