心臓弁置換患者における活性化血小板の検出とその意義 : フローサイトメトリーを用いて

フォーマット:

論文(リポジトリ)

責任表示:

堀, 知行

出版情報:

新潟医学会, 1996-02

掲載情報:

新潟医学会雑誌 — 新潟医学会雑誌

ISSN:

00290440      

著者名:

堀, 知行  

巻:

110

通号:

2

開始ページ:

78

終了ページ:

85

概要:

Thromboembolism is frequently observed in patients with prosthetic heart valve and is believed to be a major cause of post-operative morbidity and mortality. The aim of this study is to elucidate the role of activated platelets in the patie … nts with prosthetic heart valve. Forty patients (23 female and 17 male) were operated on between 1967 and 1994 for prosthetic heart valve replacement in our university. Mean age was 55 years (range 2～68). All patients received anti-coagulant therapy. In 40 patients with prosthetic heart valve and 20 normal subjects, activated platelets were detected by flow-cytometric measurement of the proteins CD62P and CD63, which are expressed on the platelet surface membrane during platelet activation. Among healthy volunteers, a small percentage of platelets were activated (CD62P: 3.14±0.82%, CD63: 3.53±1.29%). In contrast, the patients group showed increased percentage of activated platelets. (CD62P: 4.08±2.25%, p=N.S., CD63: 4.82±2.70%, p<0.05). In order to elucidate the pathophysiological role of the activated platelets in the patients, the 40 patients were divided into two groups according to the percentage of the activated platelets; activated platelets group (CD62P≧4.77% or CD63≧6.26%) and non-activated platelets group (CD62P<4.77% and CD63<6.26%). In the two groups, I analyzed the difference of four clinical factors, 1) history of prior cerebral infarction, 2) adequacy of anti-coagulant therapy (thrombotest<15% or not), 3) heart rhythm (atrial fibrillation or sinus rhythm) and, 4) anti-platelet therapy. In the four clinical factors, the history of prior cerebral infarction was significantly higher in the activated group than the non-activated group. These results suggest that activated platelets actually circulate in the peripheral blood of the patients with prosthetic heart valve and are involved in the pathogenesis of thromboembolism such as cerebral infarction. 続きを見る

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