Yao Hong-Xia, Huang Li, Wu Cong-Ming, Lin Li-E, Huang Zhao-Qian, Wu Ju-Feng, Wang Shu-Wen, Chen Wen-Ting, Tang Rui-Mei
Department of Hematology, Hainan Provincial People Hospital, Haikou 570311, Hainan Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2009 Oct;17(5):1360-2.
This study was aimed to investigate the incidence of thrombosis in patients with primary thrombocytosis (PT) and its correlation with function changes of platelets, and to explore the effect of thromboxane A2 (TXA2) inhibitor-ozagrel sodium on platelet activity and its efficacy for prevention and treatment of thrombosis. The CD62P and PAC-1 levels on platelet surface were detected by flow cytometry; the levels of TXB2 (metabolic product of TXA2) and 6-keto-PGFIalpha (metabolic product of prostacyclin) were detected by FLISA. The function change of platelets and its correlation with thrombosis were observed and compared in PT patients with and without thrombosis. The results indicated that the TXB2, PAC-1 and CD62P level, and TXB2/6-keto-PGF1alpha ratio in PT patients with thrombosis were higher than those in PT patients without thrombosis before treatment with ozagrel sodium (p<0.01). After treatment with ozagrel sodium, the function indexes of platelets such as CD62P, PAC-1, TXB2 and TXB2/6-keto-PGF1alpha except 6-keto-PGF1alpha in PT patients with and without thrombosis decreased obviously (p<0.01), but there was no significant difference in TXB2, 6-keto-PGF1alpha and TXB2/6-keto-PGF1alpha levels between PT patients with and without thrombosis except CD62P and PAC-1. It is concluded that the multi-index of platelets in PT patients with thrombosis are higher than that in PT patients without thrombosis, the activation of platelet function is a high risk factor for thrombosis of PT patients. The ozagrel sodium can obviously reduce the platelet activation, decrease the production of TXA2 and ameliorate the TXB2/6-keto-PGF1alpha ratio. The ozagrel sodium not only possesses therapeutic effect, but also preventive efficacy for thrombosis.
本研究旨在探讨原发性血小板增多症（PT）患者血栓形成的发生率及其与血小板功能变化的相关性，并探讨血栓素A2（TXA2）抑制剂奥扎格雷钠对血小板活性的影响及其预防和治疗血栓形成的疗效。采用流式细胞术检测血小板表面CD62P和PAC-1水平；采用酶联免疫吸附测定法检测TXB2（TXA2的代谢产物）和6-酮-前列腺素F1α（前列环素的代谢产物）水平。观察并比较有血栓形成和无血栓形成的PT患者血小板功能变化及其与血栓形成的相关性。结果显示，在使用奥扎格雷钠治疗前，有血栓形成的PT患者的TXB2、PAC-1和CD62P水平以及TXB2/6-酮-前列腺素F1α比值均高于无血栓形成的PT患者（p<0.01）。使用奥扎格雷钠治疗后，有血栓形成和无血栓形成的PT患者的血小板功能指标如CD62P、PAC-1、TXB2和TXB2/6-酮-前列腺素F1α（6-酮-前列腺素F1α除外）均明显降低（p<0.01），但除CD62P和PAC-1外，有血栓形成和无血栓形成的PT患者之间TXB2、6-酮-前列腺素F1α和TXB2/6-酮-前列腺素F1α水平无显著差异。结论是，有血栓形成的PT患者的血小板多指标高于无血栓形成的PT患者，血小板功能激活是PT患者血栓形成的高危因素。奥扎格雷钠可明显降低血小板活化，减少TXA2生成，改善TXB2/6-酮-前列腺素F1α比值。奥扎格雷钠不仅具有治疗作用，而且对血栓形成具有预防效果。
