Bigalke Boris, Stellos Konstantinos, Stakos Dimitrios, Joos Thomas, Pötz Oliver, Geisler Tobias, Bischofs Christian, Kremmer Elisabeth, Krämer Björn F, Seizer Peter, May Andreas E, Lindemann Stephan, Gawaz Meinrad
Medizinische Klinik III, Eberhard Karls Universität Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.
Thromb Haemost. 2009 May;101(5):911-5. doi: 10.1160/th08-06-0399.
Platelets play a key role in the development of an acute coronary syndrome (ACS) and contribute to cardiovascular events. Platelet collagen receptor glycoprotein VI (GPVI) contributes significantly to platelet adhesion and thrombus formation in ACS. We consecutively investigated both the platelet count and the platelet surface expression of GPVI in 843 patients with a symptomatic coronary artery disease verified by coronary angiography. Four hundred fourteen patients presented with stable angina pectoris and 429 patients with ACS. Platelet surface expression of GPVI and CD62P was determined by flow cytometry and platelet count with a coulter counter, plasmatic soluble GPVI was measured by ELISA. Platelet GPVI expression in patients with ACS was compared to platelet count. Patients with ACS showed significantly elevated GPVI expression levels in the first and second quartiles of platelet count compared to patients with higher platelet count [mean fluorescence intensity (MFI) +/- standard deviation): 1(st) vs. 4(th): 20.44 +/- 6.1 vs. 18.62 +/- 3.7; p=0.012; 2(nd)vs.3(rd):21.2+/-8.5vs.18.76+/-3.7;P=0.03; 2(nd)vs.4(th): 21.2+/-8.5vs.18.62+/-3.7;P=0.004], which was paralleled in trend for the CD62P expression [MFI: 1(st) vs. 4(th): 11.2 +/- 6.8 vs. 12.3 +/- 9; p=0.057; 2(nd) vs. 3(rd): 16.3 +/- 16 vs.12.7 +/- 5.3; p=0.138; 2(nd) vs. 4(th): 16.3 +/- 16 vs.11 +/- 4.4; p=0.043]. In a subgroup of 48 patients with ACS, determination of soluble GPVI showed similar results [plasma GPVI (ng/ml): 1(st)vs.4(th): 1.6 +/- 0.6 vs. 1.2 +/- 0.4; p=0.046; 1(st) vs. 3(rd): 1.6 +/- 0.6 vs. 1.1 +/- 0.5; p=0.038; 2(nd) vs. 3(rd): 1.9 +/- 0.8 vs. 1.1 +/- 0.5; p=0.04; 2(nd) vs. 4(th): 1.9 +/- 0.8 vs. 1.2 +/- 0.4; p=0.056]. Thus, a lower platelet count comes along with a higher GPVI surface expression and plasma concentration in patients with ACS, which potentially reflects increased activation and enhanced recruitment of platelets to the site of vascular injury.
血小板在急性冠状动脉综合征（ACS）的发生发展中起关键作用，并促使心血管事件的发生。血小板胶原受体糖蛋白VI（GPVI）在ACS中对血小板黏附和血栓形成有显著作用。我们连续研究了843例经冠状动脉造影证实有症状性冠状动脉疾病患者的血小板计数及血小板表面GPVI的表达。其中414例患者表现为稳定型心绞痛，429例患者为ACS。通过流式细胞术测定血小板表面GPVI和CD62P的表达，用库尔特计数器检测血小板计数，采用酶联免疫吸附测定法（ELISA）检测血浆可溶性GPVI。将ACS患者的血小板GPVI表达与血小板计数进行比较。与血小板计数较高的患者相比，ACS患者在血小板计数的第一和第二四分位数时GPVI表达水平显著升高[平均荧光强度（MFI）±标准差：第1四分位数与第4四分位数比较：20.44±6.1 vs. 18.62±3.7；p = 0.012；第2四分位数与第3四分位数比较：21.2±8.5 vs. 18.76±3.7；P = 0.03；第2四分位数与第4四分位数比较：21.2±8.5 vs. 18.62±3.7；P = 0.004]，CD62P表达也呈类似趋势[MFI：第1四分位数与第4四分位数比较：11.2±6.8 vs. 12.3±9；p = 0.057；第2四分位数与第3四分位数比较：16.3±16 vs. 12.7±5.3；p = 0.138；第2四分位数与第4四分位数比较：16.3±16 vs. 11±4.4；p = 0.043]。在48例ACS患者的亚组中，可溶性GPVI的测定结果相似[血浆GPVI（ng/ml）：第1四分位数与第4四分位数比较：1.6±0.6 vs. 1.2±0.4；p = 0.046；第1四分位数与第3四分位数比较：1.6±0.6 vs. 1.1±0.5；p = 0.038；第2四分位数与第3四分位数比较：1.9±0.8 vs. 1.1±0.5；p = 0.04；第2四分位数与第4四分位数比较：1.9±0.8 vs. 1.2±0.4；p = 0.056]。因此，在ACS患者中，较低的血小板计数伴随着较高的GPVI表面表达和血浆浓度，这可能反映了血小板激活增加以及向血管损伤部位募集增强。
