Improvement of human platelet aggregation post-splenectomy with paraesophagogastric devascularization in chronic hepatitis B patients with cirrhotic hypersplenism
Improvement of human platelet aggregation post-splenectomy with paraesophagogastric devascularization in chronic hepatitis B patients with cirrhotic hypersplenism
复制标题
食管胃旁断流术对慢性乙型肝炎肝硬化性脾功能亢进患者脾切除术后血小板聚集的改善
DOI：
10.1080/09537104.2019.1704715
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发表时间：
2019-12
期刊：
影响因子：
3.3
通讯作者：
Li Zongfang
中科院分区：
文献类型：
--
作者：
Zhang Hui;Zhang Shaoying;Zhang Jian;Zhou Rui;Nie Yongzhan;Ren Song;Li Jun;Feng Keping;Ji Fanpu;Kong Guangyao;Li Zongfang
摘要 血小板减少症是肝硬化脾功能亢进患者常见的血液学异常。脾切除术联合食管胃旁血管断流术（SPD）是一种传统的手术疗法，可以逆转这些患者的全血细胞减少症。传统上认为血小板在止血中发挥着核心作用。但慢性乙型肝炎合并肝硬化脾功能亢进患者SPD前后血小板聚集状况尚未见报道。本研究共纳入 41 名肝硬化患者和 31 名健康对照者。通过 AggRAM® Advanced Modular System（Helena Laboratories，美国）检测血小板聚集。采用ELISA法检测与血小板聚集密切相关的细胞因子。通过流式细胞术分析评估血小板膜糖蛋白（GP）的表达。发现肝硬化患者血小板聚集明显下降，SPD后可恢复至正常水平。肝硬化患者的血浆细胞因子 HMGB1、PEDF、vWF、cAMP 和 cGMP 水平较高，SPD 后也部分改善。此外，肝硬化患者的 GPIIb/IIIa、GPIbα 和 P-选择素的表达水平比健康对照或 SPD 患者的基础水平或激活水平低得多。一般来说，SPD 通过改善血小板计数和聚集而使有出血倾向的肝硬化患者受益。 GPIIb/IIIa可能是导致SPD前后血小板聚集变化的关键膜蛋白。
Abstract Thrombocytopenia is a common hematological abnormality in patients with cirrhotic hypersplenism. Splenectomy with paraesophagogastric devascularization (SPD) is a conventional surgical therapy which can reverse pancytopenia in these patients. Platelets are traditionally recognized for their central role in hemostasis. However, the status of platelet aggregation in chronic hepatitis B patients with cirrhotic hypersplenism before and after SPD has not been reported yet. A total of 41 cirrhotic patients and 31 healthy controls were included in this study. Platelet aggregation was detected by AggRAM® Advanced Modular System (Helena Laboratories, USA). ELISA was used to detect the cytokines closely related to platelet aggregation. Expressions of platelet membrane glycoproteins (GPs) were evaluated by flow cytometric analysis. Platelet aggregation was found to be decreased distinctly in the cirrhotic patients, and to be restored to normal level after SPD. The cirrhotic patients showed higher plasma levels of the cytokines HMGB1, PEDF, vWF, cAMP and cGMP, which also improved partially after SPD. Moreover, the cirrhotic patients had much lower expression of GPIIb/IIIa, GPIbα and P-selectin than either the healthy controls or SPD patients at basal or activated level. Generally, SPD benefits cirrhotic patients with bleeding tendencies by improving platelet counts and aggregation. GPIIb/IIIa may be the key membrane protein responsible for the change in platelet aggregation before and after SPD.
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影响因子：
2.7
作者：
Lv Y;Lau WY;Li Y;Deng J;Han X;Gong X;Liu N;Wu H
通讯作者：
Wu H
影响因子：
3.3
作者：
Frelinger, Andrew L., III
通讯作者：
Frelinger, Andrew L., III
DOI：
10.1007/978-3-642-37078-6_144
发表时间：
2015-01-23
期刊：
PanVascular Medicine
影响因子：
--
作者：
Morales-Ruiz M;Rodríguez-Vita J;Ribera J;Jiménez W
通讯作者：
Jiménez W
影响因子：
7.5
作者：
Alkozai, Edris M.;Porte, Robert J.;Lisman, Ton
通讯作者：
Lisman, Ton
影响因子：
4.1
作者：
Llop, Elba;Lopez, Marta;Luis Calleja, Jose
通讯作者：
Luis Calleja, Jose