Reduced platelet activation and platelet aggregation in patients with alcoholic liver cirrhosis
Reduced platelet activation and platelet aggregation in patients with alcoholic liver cirrhosis
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DOI：
10.1080/09537104.2017.1349308
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发表时间：
2018-01-01
期刊：
影响因子：
3.3
通讯作者：
Nybo, Mads
中科院分区：
文献类型：
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作者：
Vinholt, Pernille Just;Hvas, Anne-Mette;Nybo, Mads
以往关于肝硬化患者血小板功能的研究结果并不一致。目的：探讨酒精性肝硬化患者血小板活化和聚集功能。我们纳入了27名酒精性肝硬化患者和22名健康人。最近建立的流式细胞术方法用于测量血小板活化和血小板聚集，独立于样本血小板计数。使用光透射聚集测定法（LTA）进一步研究血小板聚集（血小板计数>100 x 10（9）/L）。血小板激动剂为二磷酸腺苷、凝血酶受体激活肽、花生四烯酸、胶原和胶原相关肽。患者的血小板计数中位数低于健康个体，分别为125 x 10（9）/L（四分位数间距[IQR] 90-185）和240 x 10（9）（IQR 204 - 285），p < 0.001。刺激样本中的血小板活化水平在患者中低于健康个体，例如，在胶原相关肽刺激后，患者中活化糖蛋白B/IIIa阳性的血小板百分比中位数为85%（IQR 70-94），而健康个体中为97%（IQR 94-99），p < 0.001;较低的血小板活化能力与低血小板计数和Child-Pugh B/C级肝硬化相关。流式细胞术血小板聚集减少患者的胶原相关肽和腺苷二磷酸，例如，对于胶原相关肽，患者的血小板聚集（平均值+/-标准差）为57% +/- 4，而健康个体为70% +/- 1，p = 0.01。与健康人相比，轻度LTA显示部分患者胶原诱导的血小板聚集减少。结论：酒精性肝硬化患者血小板功能降低，其严重程度与血小板计数及肝硬化程度有关。
Results from previous studies regarding platelet function in liver cirrhosis are discordant. The aim was to investigate platelet activation and platelet aggregation in patients with alcoholic liver cirrhosis. We included 27 patients with alcoholic liver cirrhosis and 22 healthy individuals. A recently established flow cytometric approach was used to measure platelet activation and platelet aggregation independent of sample platelet count. Platelet aggregation was further investigated using light transmission aggregometry (LTA) (for platelet count >100 x 10(9)/L). Platelet agonists were adenosine diphosphate, thrombin receptor-activating peptide, arachidonic acid, collagen, and collagen-related peptide. Patients had lower median platelet count than healthy individuals, 125 x 10(9)/L (interquartile range [IQR] 90-185) versus 240 x 10(9) (IQR 204 285), p < 0.001. Platelet activation levels in stimulated samples were lower in patients versus healthy individuals, e.g., after collagen-related peptide stimulation, the median percentage of platelets positive for activated glycoprotein llb/llla was 85% (IQR 70-94) in patients versus 97% (IQR 94-99) in healthy individuals, p < 0.001; lower platelet activation capacity being associated with low platelet count and Child-Pugh class B/C cirrhosis. Flow cytometric platelet aggregation was reduced in patients for collagen-related peptide and for adenosine diphosphate, e.g., platelet aggregation (mean +/- standard deviation) was 57% +/- 4 in patients versus 70% +/- 1 in healthy individuals for collagen-related peptide, p = 0.01. Light LTA showed reduced collagen-induced platelet aggregation in some patients compared with healthy individuals. In conclusion, platelet function was reduced in some patients with alcoholic liver cirrhosis and the severity was associated with platelet count and severity of liver cirrhosis.