CD62P（P-选择素）表达作为有无胆汁淤积的肝硬化患者血小板活化标志物。
CD62P (P-selectin) expression as a platelet activation marker in patients with liver cirrhosis with and without cholestasis.
作者信息
Hegazy Sara, Elsabaawy Maha, Eltabakh Mohamed, Hammad Reham, Bedair Hanan
机构信息
National Liver Institute, Menoufia University, Egypt.
出版信息
Clin Exp Hepatol. 2021 Jun;7(2):231-240. doi: 10.5114/ceh.2021.107566. Epub 2021 Jun 30.
AIM OF THE STUDY
P-selectin (CD62P) is a platelet activation marker that was claimed to mediate the accumulation of platelets induced by cholestasis. The nature of platelet dysfunction and hemostasis abnormalities in cholestatic liver disease needs to be more explored. The aim of this study was to assess platelet CD62P expression in cirrhotic patients with and without cholestasis, and to evaluate its relationship with a bleeding tendency.
MATERIAL AND METHODS
150 patients were included in this case-control study. Participants were divided into 84 patients with liver cirrhosis (group I), 44 of whom had cholestasis (Group Ia) and 40 patients were without cholestasis (group Ib); 36 patients who were cholestatic without liver cirrhosis (group II); and 30 healthy subjects who formed the control group (group III). Platelet CD62P expression was assessed by a flow cytometer.
RESULTS
Platelets expressing CD62P were significantly increased in all patient groups compared to controls ( < 0.001). Platelets expressing CD62P were significantly increased in gastrointestinal (GIT) bleeders compared to non-bleeders in cirrhotic and cholestatic groups ( < 0.001 each). Among group I patients at cut-off > 12.4, up-regulation of platelet CD62P yielded 72% sensitivity and 44.1% specificity to discriminate bleeders from non-bleeders ( = 0.01), while among group II at cut-off > 12.9, it yielded 90% sensitivity and 80.8% specificity ( < 0.001). In cirrhotic patients, platelet CD62P expression was significantly increased in patients with an advanced Child-Pugh class ( < 0.001). Platelet expressing CD62P was shown as an independent risk factor for bleeding among cirrhotic cases with an odds ratio of 1.07 and CI 0.99-1.15.
CONCLUSIONS
Up-regulation of platelet CD62P expression can serve as a GIT bleeding predictor in liver cirrhosis.
研究目的
P-选择素（CD62P）是一种血小板活化标志物，据称其介导胆汁淤积诱导的血小板聚集。胆汁淤积性肝病中血小板功能障碍和止血异常的本质需要进一步探索。本研究的目的是评估有和无胆汁淤积的肝硬化患者血小板CD62P的表达，并评估其与出血倾向的关系。
材料与方法
本病例对照研究纳入150例患者。参与者分为84例肝硬化患者（I组），其中44例有胆汁淤积（Ia组），40例无胆汁淤积（Ib组）；36例无肝硬化的胆汁淤积患者（II组）；以及30名健康受试者作为对照组（III组）。通过流式细胞仪评估血小板CD62P的表达。
结果
与对照组相比，所有患者组中表达CD62P的血小板均显著增加（<0.001）。在肝硬化和胆汁淤积组中，与未出血者相比，胃肠道（GIT）出血者中表达CD62P的血小板显著增加（每组<0.001）。在I组患者中，截断值>12.4时，血小板CD62P上调对区分出血者和未出血者的敏感性为72%，特异性为44.1%（=0.01），而在II组中，截断值>12.9时，敏感性为90%，特异性为80.8%（<0.001）。在肝硬化患者中，Child-Pugh分级晚期患者的血小板CD62P表达显著增加（<0.001）。在肝硬化病例中，表达CD62P的血小板被证明是出血的独立危险因素，比值比为1.07，可信区间为0.99-1.15。
结论
血小板CD62P表达上调可作为肝硬化患者GIT出血的预测指标。
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