Kondo C, Tanaka K, Takagi K, Shimono T, Shinpo H, Yada I, Yuasa H, Kusagawa M, Akamatsu N, Tanoue K
Department of Thoracic Surgery, Mie University School of Medicine, Japan.
ASAIO J. 1993 Jul-Sep;39(3):M550-3.
Changes in platelet membrane glycoproteins (GPIb, GPIIb/IIIa, and GMP-140) were evaluated using flow cytometry after binding with monoclonal antibodies in 22 adult patients undergoing cardiopulmonary bypass (CPB) surgery. The amount of GPIb on platelets decreased significantly during CPB, reaching a minimum level of 64 +/- 26% of the pre CPB value at 120 min of CPB. There was no significant change in the amount of GPIIb/IIIa on platelets. In accordance with these changes, ristocetin induced agglutination decreased to 56.7 +/- 16.2% of the pre CPB value during CPB. However, there were no significant changes in ADP and collagen induced aggregation throughout the procedure. The number of the activated platelets expressing GMP-140 on their surfaces increased significantly during CPB. There was an upper limit to the amount of GMP-140 expression on each platelet in the circulating blood, suggesting that excessively activated platelets are removed from the circulation. The authors conclude that CPB reduces the amount of GPIb on platelets, which results in platelet dysfunction. In addition, removal of excessively activated platelets from the circulation may lead to thrombocytopenia after CPB.
在22例接受体外循环（CPB）手术的成年患者中，使用流式细胞术评估血小板膜糖蛋白（GPIb、GPIIb/IIIa和GMP-140）与单克隆抗体结合后的变化。CPB期间血小板上GPIb的量显著减少，在CPB 120分钟时降至CPB前值的64±26%的最低水平。血小板上GPIIb/IIIa的量没有显著变化。与这些变化一致，CPB期间瑞斯托霉素诱导的凝集降至CPB前值的56.7±16.2%。然而，在整个过程中，ADP和胶原诱导的聚集没有显著变化。CPB期间，表面表达GMP-140的活化血小板数量显著增加。循环血液中每个血小板上GMP-140的表达量有上限，这表明过度活化的血小板会从循环中被清除。作者得出结论，CPB会减少血小板上GPIb的量，从而导致血小板功能障碍。此外，从循环中清除过度活化的血小板可能导致CPB后血小板减少。
