Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Clin Appl Thromb Hemost. 2013 Jul-Aug;19(4):424-32. doi: 10.1177/1076029612456733. Epub 2012 Aug 21.
Platelet microparticles (PMPs) and function profile in children with congenital heart disease (CHD) have not been widely explored. We investigated platelet aggregation, flow cytometric platelet surface receptors (P-selectin and glycoprotein (GP) IIb/IIIa) and PMPs in 23 children with cyanotic CHD (CCHD), 30 children with acyanotic CHD (ACHD) and 30 healthy controls correlating these variables to hematological and coagulation parameters including von Willebrand factor antigen (vWF Ag) as a marker of endothelial dysfunction. Hemoglobin, hematocrit (HCT), D-dimer, and vWF Ag were significantly higher in CCHD than ACHD group. Platelet MPs and P-selectin expression were increased in patients than controls, particularly in CCHD and positively correlated to HCT, D-dimer, and vWF Ag while platelet count, aggregation, and GP IIb/IIIa expression were decreased in CCHD compared with ACHD group and negatively correlated to HCT. The overproduction of PMPs and platelet activation with suppressed aggregation may be implicated in the pathogenesis of coagulation/hemostatic abnormalities in children with CCHD.
血小板微粒（PMPs）及其在先天性心脏病（CHD）患儿中的功能特征尚未得到广泛研究。我们研究了 23 例紫绀型先天性心脏病（CCHD）患儿、30 例非紫绀型先天性心脏病（ACHD）患儿和 30 例健康对照者的血小板聚集、流式细胞术血小板表面受体（P-选择素和糖蛋白（GP）IIb/IIIa）和 PMPs，并将这些变量与包括血管性血友病因子抗原（vWF Ag）在内的血液学和凝血参数相关联，作为内皮功能障碍的标志物。CCHD 组的血红蛋白、血细胞比容（HCT）、D-二聚体和 vWF Ag 明显高于 ACHD 组。与对照组相比，患者的血小板 MPs 和 P-选择素表达增加，尤其是在 CCHD 中，且与 HCT、D-二聚体和 vWF Ag 呈正相关，而血小板计数、聚集和 GP IIb/IIIa 表达在 CCHD 中降低与 ACHD 组相比，且与 HCT 呈负相关。PMPs 的过度产生和血小板激活伴聚集抑制可能与 CCHD 患儿凝血/止血异常的发病机制有关。
