Marquardt L, Anders C, Buggle F, Palm F, Hellstern P, Grau A J
Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany.
Cerebrovasc Dis. 2009;28(3):276-82. doi: 10.1159/000228710. Epub 2009 Jul 16.
Leukocyte-platelet aggregates appear to be a stable and sensitive marker of platelet activation as suggested by studies in coronary heart disease. We tested the hypothesis that leukocyte-platelet aggregates are increased after ischemic stroke and investigated the contribution of different leukocyte subtypes to such increase.
We serially determined granulocyte-, lymphocyte- and monocyte-platelet aggregates, using flow cytometry at days 1, 2, 3, 5, 7, 10, and 90 in patients with ischemic stroke (n = 45) and in age- and sex-matched healthy control subjects (n = 30).
Granulocyte-platelet aggregates (granulocytes with > or =1 platelet/microl) were more common in patients than control subjects from day 1 through day 10 (p < 0.04, respectively), but not on day 90 after stroke. The percentage of granulocytes forming aggregates was increased on days 1-3 after stroke but not at other time points. Lymphocyte-platelet aggregates were not more common at any time point after stroke. Total numbers and percentages of monocytes forming platelet aggregates were significantly increased on day 2 (p = 0.003), but not at other time points after stroke.
The 3 leukocyte subtypes showed different kinetics regarding aggregate formation with platelets after ischemic stroke. Increase of monocyte-platelet aggregates is short-lived and may reflect an acute reaction to cerebral ischemia, whereas granulocyte-platelet aggregate formation persists into the subacute phase, suggesting that they are a particularly sensitive parameter reflecting both prothrombotic and inflammatory processes after stroke.
正如冠心病研究中所表明的那样，白细胞-血小板聚集体似乎是血小板活化的一个稳定且敏感的标志物。我们检验了以下假设：缺血性中风后白细胞-血小板聚集体会增加，并研究了不同白细胞亚型对这种增加的作用。
我们在缺血性中风患者（n = 45）以及年龄和性别匹配的健康对照者（n = 30）中，于第1、2、3、5、7、10和90天使用流式细胞术连续测定粒细胞-血小板聚集体、淋巴细胞-血小板聚集体和单核细胞-血小板聚集体。
从第1天到第10天，粒细胞-血小板聚集体（每微升有≥1个血小板的粒细胞）在患者中比对照者更常见（p分别<0.04），但在中风后第90天并非如此。中风后第1 - 3天形成聚集体的粒细胞百分比增加，但在其他时间点未增加。中风后任何时间点淋巴细胞-血小板聚集体都没有更常见。形成血小板聚集体的单核细胞总数和百分比在第2天显著增加（p = 0.003），但在中风后的其他时间点未增加。
缺血性中风后，这三种白细胞亚型在与血小板形成聚集体方面表现出不同的动力学。单核细胞-血小板聚集体的增加是短暂的，可能反映了对脑缺血的急性反应，而粒细胞-血小板聚集体的形成持续到亚急性期，这表明它们是反映中风后血栓形成和炎症过程的一个特别敏感的参数。
