Cuenca R, Fernández-Cortijo J, Lima J, Fonollosa V, Simeón C P, Pico M, Soriano B, Vilardell M
Servicio de Medicina Interna, Hospital General Vall d'Hebron, Barcelona.
Med Clin (Barc). 1990 Dec 8;95(20):761-3.
We evaluated platelet function in 59 patients with Raynaud's phenomenon (RP): 24 had primary RP (PRP) and in 35 RP was associated with diffuse scleroderma (DS). In the group with PRP there were 10 males and 14 females, with a mean age of 43 +/- 12 years and a time of evolution of 5 +/- 5 years. In the group with RP associated with DS there were 31 females and 4 males with a mean age of 53 +/- 12 years and a time of evolution of 9 +/- 7 years. The control group consisted of 20 healthy individuals (14 males and 6 females with a mean age of 40 +/- 12 years). In all patients and controls beta-thromboglobulin (BTG) and platelet factor 4 (PF4) levels were measured in plasma, and platelet aggregation was evaluated in the presence of adenosine diphosphate (ADP), collagen and arachidonic acid. The patients with RP associated with DS had BTG and PF4 higher than those with PRP and controls (p less than 0.02). The BTG/PF4 ratio was also significantly greater in patients with DS (p less than 0.005). The platelets from patients with DS had a greater aggregation with ADP (1 microM and 0.5 microM) than those from PRP (p less than 0.03). We concluded that patients with RP associated with DS had in vivo activation and a greater aggregation of platelets, in contrast with the absence of these findings in the group with PRP and in controls.
我们评估了59例雷诺现象（RP）患者的血小板功能：24例为原发性RP（PRP），35例RP与弥漫性硬皮病（DS）相关。PRP组有10名男性和14名女性，平均年龄43±12岁，病程5±5年。DS相关RP组有31名女性和4名男性，平均年龄53±12岁，病程9±7年。对照组由20名健康个体组成（14名男性和6名女性，平均年龄40±12岁）。对所有患者和对照组均检测血浆中的β-血小板球蛋白（BTG）和血小板因子4（PF4）水平，并在二磷酸腺苷（ADP）、胶原和花生四烯酸存在的情况下评估血小板聚集情况。DS相关RP患者的BTG和PF4水平高于PRP患者和对照组（p<0.02）。DS患者的BTG/PF4比值也显著更高（p<0.005）。DS患者的血小板对ADP（1μM和0.5μM）的聚集程度高于PRP患者（p<0.03）。我们得出结论，与PRP组和对照组未出现这些结果相反，DS相关RP患者存在体内血小板激活和更大程度的聚集。
