Kawabata K, Nagake Y, Shikata K, Fukuda S, Nakazono H, Takahashi M, Ichikawa H, Makino H
Department of Medicine III, Okayama University Medical School, Japan.
Nephron. 1998;78(2):148-55. doi: 10.1159/000044903.
During hemodialysis, platelets are activated across a dialyzer. Soluble P-selectin (sP-selectin) is a form of P-selectin which is a glycoprotein relocated from secretory granules to the surfaces of platelets and endothelial cells after these cells have been physiologically activated. To investigate whether sP-selectin is useful as a marker of platelet activation during hemodialysis, we measured the plasma concentration of sP-selectin by enzyme-linked immunosorbent assay in 6 patients hemodialyzed in our institute using regenerated cellulose (RC) membranes and thereafter polysulfone membranes. Concomitantly, we also measured the plasma concentration of platelet factor 4 and beta-thromboglobulin which are released from alpha-granules of activated platelets. During hemodialysis with RC membranes, the beta-thromboglobulin level was significantly increased 15 min (p < 0.05) and the sP-selectin level 15 (p < 0.05) and 180 min (p < 0.05) after initiation of dialysis on the venous side as compared with the arterial side of the hemodialyzer. During hemodialysis with polysulfone membranes, no significant variation in plasma beta-thromboglobulin and sP-selectin levels was detected. The platelet factor 4 level increased more significantly across a dialyzer 180 min after initiation of dialysis with RC than with polysulfone membranes (p < 0.01). The changes in plasma platelet factor 4 and beta-thromboglobulin levels demonstrated that platelets are more activated during hemodialysis with RC than with polysulfone membranes. The changes in plasma sP-selectin levels during hemodialysis with RC confirm that the release of P-selectin purely from activated platelets was detected by enzyme-linked immunosorbent assay. sP-selectin may be a marker of platelet activation during hemodialysis.
血液透析过程中，血小板会在透析器中被激活。可溶性P选择素（sP选择素）是P选择素的一种形式，P选择素是一种糖蛋白，在血小板和内皮细胞被生理激活后，从分泌颗粒重新定位到细胞表面。为了研究sP选择素是否可作为血液透析期间血小板激活的标志物，我们采用酶联免疫吸附测定法，对我院使用再生纤维素（RC）膜及之后使用聚砜膜进行血液透析的6例患者的血浆sP选择素浓度进行了测量。同时，我们还测量了从活化血小板的α颗粒中释放的血小板第4因子和β-血小板球蛋白的血浆浓度。在使用RC膜进行血液透析期间，与透析器动脉端相比，静脉端透析开始后15分钟时β-血小板球蛋白水平显著升高（p<0.05），sP选择素水平在15分钟（p<0.05）和180分钟（p<0.05）时显著升高。在使用聚砜膜进行血液透析期间，未检测到血浆β-血小板球蛋白和sP选择素水平有显著变化。与聚砜膜相比，使用RC膜透析开始180分钟后，透析器两端血小板第4因子水平升高更为显著（p<0.01）。血浆血小板第4因子和β-血小板球蛋白水平的变化表明，与聚砜膜相比，使用RC膜进行血液透析时血小板激活更为明显。使用RC膜进行血液透析期间血浆sP选择素水平的变化证实，通过酶联免疫吸附测定法可检测到仅从活化血小板释放的P选择素。sP选择素可能是血液透析期间血小板激活的标志物。
