血小板功能与 HIV：一项病例对照研究。

Platelet function and HIV: a case-control study.

机构信息

School of Medicine and Medical Sciences, University College Dublin, Ireland.

出版信息

AIDS. 2010 Mar 13;24(5):649-57. doi: 10.1097/QAD.0b013e328336098c.

DOI:10.1097/QAD.0b013e328336098c

PMID:20177361

Abstract

OBJECTIVE

Cardiovascular disease and myocardial infarction are of increasing concern in HIV-infected populations. Although platelets mediate arterial thrombosis, central to myocardial infarction, data on platelet function in HIV infection are lacking. We hypothesized that HIV-infected patients would have altered platelet reactivity.

DESIGN

A case-control study of platelet reactivity in 20 HIV-infected (HIVpos) and 20 age and sex-matched HIV-negative (HIVneg) individuals.

METHODS

Time-dependent platelet aggregation was measured in response to increasing concentrations of platelet agonists: epinephrine, collagen, thrombin receptor-activating peptide and ADP using light absorbance.

RESULTS

In both groups, mean age was 34 years, and 65% were men. Sixteen out of 20 (80%) of the HIVpos patients were on antiretroviral therapy with 12 out of 20 (60%) patients having HIV RNA less than 50 copies/ml. There were significant between-group differences in platelet reactivity across all four agonists. Platelets from HIVpos patients were more reactive to epinephrine [mean (SD) log concentration required to induce 50% maximal aggregation, 1.9 (1.2) versus 3.0 (1.7) mumol/l in HIVneg individuals, P = 0.028], whereas less platelet aggregation was observed in response to submaximal concentrations of the other agonists [thrombin receptor-activating peptide 72.5 (14.5)% versus 82.2 (7.6)% at 10 mumol/l, P = 0.011; ADP 67.3 (12.1)% versus 75.2 (8.8)% at 10 mumol/l, P = 0.035; collagen 16.6 (25.1)% versus 35.4 (31.5)% at 71.25 microg/ml, P = 0.007].

CONCLUSION

Between-group differences in platelet responses to all agonists suggest multiple underlying defects in platelet function in HIV infection. Further research is required to determine the contribution of antiretroviral therapy and relationships between platelet function and the increased cardiovascular disease observed in HIV-infected populations.

摘要

目的

心血管疾病和心肌梗死在 HIV 感染者中日益受到关注。尽管血小板介导动脉血栓形成，这是心肌梗死的核心，但关于 HIV 感染中血小板功能的数据却很缺乏。我们假设 HIV 感染者的血小板反应性会发生改变。

设计

对 20 名 HIV 感染（HIVpos）和 20 名年龄和性别匹配的 HIV 阴性（HIVneg）个体的血小板反应性进行病例对照研究。

方法

使用光吸收法测量血小板在不同浓度的血小板激动剂（肾上腺素、胶原、血栓素受体激活肽和 ADP）作用下的时相依赖性聚集。

结果

两组的平均年龄均为 34 岁，65%为男性。20 名 HIVpos 患者中有 16 名（80%）正在接受抗逆转录病毒治疗，其中 12 名（60%）患者的 HIV RNA 小于 50 拷贝/ml。在所有四种激动剂中，HIVpos 患者的血小板反应性存在显著的组间差异。HIVpos 患者的血小板对肾上腺素的反应性更高[诱导 50%最大聚集所需的平均（SD）对数浓度，HIVneg 个体为 1.9（1.2）µmol/L，而 HIVpos 个体为 3.0（1.7）µmol/L，P = 0.028]，而对其他激动剂的亚最大浓度的血小板聚集反应性较低[血栓素受体激活肽 10µmol/L 时为 72.5（14.5）%，而 HIVneg 个体为 82.2（7.6）%，P = 0.011；ADP 10µmol/L 时为 67.3（12.1）%，而 HIVneg 个体为 75.2（8.8）%，P = 0.035；胶原 71.25µg/ml 时为 16.6（25.1）%，而 HIVneg 个体为 35.4（31.5）%，P = 0.007]。