Baumann B, Hillmar I, Hehlmann R
Medizinische Poliklinik der Universität München.
Klin Wochenschr. 1988 Mar 1;66(5):199-207. doi: 10.1007/BF01728197.
Blood of 16 patients with essential thrombocythemia (ET), 9 patients with reactive thrombocytosis (RT) and 13 healthy persons was used for platelet aggregation studies. When the aggregation was induced with adenosine diphosphate (0.01 microM), collagen (0.1 micrograms/ml) or platelet activating factor (PAF 0.5 microM) the plasma of the patients with ET showed significantly decreased aggregation (35%-44% of the value for the control groups). Independent of inhibitors of platelet aggregation, thrombin (0.05 U/ml) caused similar aggregation in healthy controls and patients with ET; patients with RT showed an increase aggregation. Adrenalin-induced aggregation discriminated best between patients with ET and controls. Adrenalin in concentrations ranging from 0.01 micrograms/ml to 100 micrograms/ml caused comparable dose-related amounts of aggregation in healthy controls and patients with RT. Over the whole concentration range, patients with ET showed significantly decreased aggregation (28%-34% of the value for the control groups). This difference proved to be independent of the influence of inhibitors of platelet aggregation. Though concentrations of alpha1-acid glycoprotein never reached inhibitory levels in the plasma of patients with ET (n = 12) they were significantly higher compared with those in normal plasma (n = 12). Fibrinogen concentrations in plasma of ET-patients (n = 12) were in the normal range. Cellular adenosine 3'-5'-cyclic monophosphate concentrations in ET (n = 10) are comparable with normal values (n = 5). The significance of the results for diagnosis and better pathophysiological understanding of ET is discussed.
选取16例原发性血小板增多症(ET)患者、9例反应性血小板增多症(RT)患者的血液以及13名健康人的血液用于血小板聚集研究。当用二磷酸腺苷(0.01微摩尔)、胶原蛋白(0.1微克/毫升)或血小板活化因子(PAF 0.5微摩尔)诱导聚集时,ET患者的血浆显示聚集显著降低(为对照组值的35%-44%)。与血小板聚集抑制剂无关,凝血酶(0.05单位/毫升)在健康对照组和ET患者中引起相似的聚集;RT患者显示聚集增加。肾上腺素诱导的聚集在ET患者和对照组之间区分效果最佳。浓度范围为0.01微克/毫升至100微克/毫升的肾上腺素在健康对照组和RT患者中引起相当的剂量相关聚集量。在整个浓度范围内,ET患者显示聚集显著降低(为对照组值的28%-34%)。这种差异被证明与血小板聚集抑制剂的影响无关。尽管ET患者(n = 12)血浆中的α1-酸性糖蛋白浓度从未达到抑制水平,但与正常血浆(n = 12)相比显著更高。ET患者(n = 12)血浆中的纤维蛋白原浓度在正常范围内。ET患者(n = 10)细胞内的腺苷3'-5'-环磷酸浓度与正常值(n = 5)相当。讨论了这些结果对ET诊断和更好地理解其病理生理学的意义。