Ahn Y S, Jy W, Kolodny L, Horstman L L, Mao W W, Valant P A, Duncan R C
William J. Harrington Center for Blood Diseases, Department of Medicine, University of Miami School of Medicine, Florida 33136, USA.
Br J Haematol. 1996 Nov;95(2):408-15. doi: 10.1046/j.1365-2141.1996.d01-1902.x.
Circulating activated platelet aggregates (aPA) were assayed by flow cytometry employing mAb alpha-CD62p in eight patients with thrombotic thrombocytopenic purpura (TTP). Elevation of aPA was observed in all patients in active stages of TTP; aPA normalized in remission. Plasma infusions with plasmapheresis decreased aPA in responding patients. The rise and fall of aPA preceded relapses and improvements, respectively. These changes were seen prior to the traditional indicators, LDH, haematocrit, and platelet count. Incubation of plasma from TTP patients with normal whole blood induced formation of aPA; this effect was significantly greater than that of plasmas from ITP patient controls (P < 0.01), suggesting the presence of an aPA-promoting factor in TTP plasma. Parallel experiments using a platelet aggregometer failed to detect effect of TTP plasma on normal blood. In summary, aPA appear to be a marker of disease activity, rising with relapse, falling with plasma therapy, and normalizing in remission. The flow cytometric assay of aPA is more sensitive than aggregometry in detecting the putative aPA-promoting factor in TTP.
采用单克隆抗体α-CD62p，通过流式细胞术对8例血栓性血小板减少性紫癜（TTP）患者的循环活化血小板聚集体（aPA）进行检测。在TTP活动期的所有患者中均观察到aPA升高；缓解期aPA恢复正常。血浆置换联合血浆输注可使有反应的患者aPA降低。aPA的升高和降低分别先于病情复发和改善。这些变化在传统指标乳酸脱氢酶（LDH）、血细胞比容和血小板计数出现之前就已出现。将TTP患者的血浆与正常全血孵育可诱导aPA形成；这种效应明显大于特发性血小板减少性紫癜（ITP）患者对照血浆的效应（P<0.01），提示TTP血浆中存在aPA促进因子。使用血小板聚集仪进行的平行实验未能检测到TTP血浆对正常血液的影响。总之，aPA似乎是疾病活动的标志物，随病情复发而升高，随血浆治疗而降低，缓解期恢复正常。在检测TTP中假定的aPA促进因子方面，aPA的流式细胞术检测比聚集测定法更敏感。
