Division of General Internal Medicine, University of Utah School of Medicine, Salt Lake City; Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City.
Department of Internal Medicine, and the Program in Molecular Medicine, University of Utah School of Medicine, Salt Lake City.
Chest. 2012 Jun;141(6):1490-1495. doi: 10.1378/chest.11-2860. Epub 2012 Mar 1.
Changes in platelet reactivity during 2009 influenza A(H1N1) (A[H1N1]) have not been characterized.
We prospectively examined platelet activation and cytokine responses in patients with A(H1N1) (n = 20), matched patients with bacterial pneumonia (n = 15), and nonhospitalized, healthy control subjects (n = 10).
Platelet-monocyte aggregation was higher in patients with A(H1N1) (21.4% ± 4.7%) compared with patients with pneumonia (10.9% ± 3.7%) and control subjects (8.1% ± 4.5%, P < .05). Similarly, PAC-1 (antibody that binds to the active conformation of integrin α(IIb)β(3)) binding to platelets is increased in patients with A(H1N1) (9.5% ± 4.7%) compared with patients with pneumonia (1.0% ± 0.7%) and healthy subjects (0.61% ± 0.15%, P < .10). PAC-1 binding was twofold higher in patients with A(H1N1) with shock vs those without shock. IL-6 levels were elevated in patients with A(H1N1), indicating systemic inflammation consistent with activation of circulating platelets.
These findings, derived from a small but documented cohort of patients, demonstrate that platelet activation responses during A(H1N1) are enhanced-exceeding responses in patients with bacterial pneumonia-and provide new evidence that platelets may contribute to inflammatory responses during A(H1N1).
2009 年甲型 H1N1（A[H1N1]）流感期间血小板反应性的变化尚未得到描述。
我们前瞻性地研究了甲型 H1N1（A[H1N1]）患者（n=20）、细菌性肺炎患者（n=15）和非住院健康对照者（n=10）的血小板活化和细胞因子反应。
与肺炎患者（10.9%±3.7%）和健康对照者（8.1%±4.5%，P<0.05）相比，A（H1N1）患者的血小板-单核细胞聚集率更高（21.4%±4.7%）。同样，PAC-1（与整合素α(IIb)β(3)的活性构象结合的抗体）与血小板的结合在 A（H1N1）患者中增加（9.5%±4.7%），与肺炎患者（1.0%±0.7%）和健康受试者（0.61%±0.15%）相比，差异有统计学意义（P<0.10）。伴有休克的 A（H1N1）患者与无休克的患者相比，PAC-1 结合增加了两倍。A（H1N1）患者的白细胞介素 6（IL-6）水平升高，表明存在全身性炎症，这与循环血小板的活化一致。
这些发现来自于一个经过充分记录的小患者队列，表明在 A（H1N1）期间血小板活化反应增强——超过了细菌性肺炎患者的反应——并提供了新的证据表明血小板可能有助于 A（H1N1）期间的炎症反应。
