Dechavanne M, Ffrench M, Pages J, Ffrench P, Boukerche H, Bryon P A, McGregor J L
Thromb Haemost. 1987 Feb 3;57(1):106-9.
Extracorporeal circulation (ECC) used in open heart surgery gives rise to several hemostatic defects. This work investigates the effect of ECC on patient platelets membrane glycoproteins IIb/IIIa. A monoclonal antibody (LYP 18) directed against the IIb/IIIa complex was used on patient platelets in binding and flow cytometry studies, before and at the end of ECC. An antithrombospondin (LYP 8) monoclonal antibody and a monoclonal antibody (LYP 7) directed against an alpha-granule glycoprotein of 136 kdaltons, present on the platelet surface after secretion, were used in binding studies together with electron microscopy to assess the release of alpha-granules. Results obtained in 7 patients show a significant reduction (p less than 0.02) in the number of LYP 18 monoclonal antibody binding to platelets having undergone ECC (n = 49,725 +/- 16,275) compared to platelets drawn before ECC (n = 72,671 +/- 13,302). Flow cytometry studies indicate a decrease (p less than 0.02) in the percentage of platelets bearing the LYP 18 determinant following ECC (75 +/- 12% vs 66 +/- 14%). Binding of monoclonal antibodies LYP 8 and LYP 7 and electron microscopy studies of patient platelets having undergone ECC do not show degranulation. These results suggest possible cleavage of the IIb/IIIa complex following ECC but no release of alpha-granules.
心脏直视手术中使用的体外循环（ECC）会引发多种止血缺陷。本研究探讨了ECC对患者血小板膜糖蛋白IIb/IIIa的影响。在ECC开始前及结束时，使用一种针对IIb/IIIa复合物的单克隆抗体（LYP 18）对患者血小板进行结合和流式细胞术研究。使用一种抗血小板反应蛋白（LYP 8）单克隆抗体和一种针对分泌后存在于血小板表面的136千道尔顿α颗粒糖蛋白的单克隆抗体（LYP 7），结合电子显微镜进行结合研究，以评估α颗粒的释放情况。7例患者的研究结果显示，与ECC前采集的血小板（n = 72,671 +/- 13,302）相比，接受ECC后的血小板（n = 49,725 +/- 16,275）上LYP 18单克隆抗体的结合数量显著减少（p < 0.02）。流式细胞术研究表明，ECC后携带LYP 18决定簇的血小板百分比降低（p < 0.02）（75 +/- 12%对66 +/- 14%）。接受ECC的患者血小板的LYP 8和LYP 7单克隆抗体结合及电子显微镜研究未显示脱颗粒现象。这些结果提示ECC后IIb/IIIa复合物可能发生裂解，但无α颗粒释放。
