PLATELET HYPERAGGREGABILITY AND THE NEPHROTIC SYNDROME
PLATELET HYPERAGGREGABILITY AND THE NEPHROTIC SYNDROME
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DOI：
10.1016/0049-3848(79)90082-3
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发表时间：
1979-01-01
影响因子：
7.5
通讯作者：
SILVER, MJ
中科院分区：
文献类型：
--
作者：
REMUZZI, G;MECCA, G;SILVER, MJ
本文对19例肾病综合征患者的低循环血清白蛋白水平与花生四烯酸、二磷酸腺苷、胶原诱导的血小板聚集超敏反应的关系进行了研究。在16名健康志愿者中也进行了类似的研究。所有患者的血浆白蛋白正常水平都异常低或低，白蛋白是一种可能调节血小板聚集和前列腺素合成的蛋白质。诱导患者富血小板血浆聚集所需的平均阈值浓度分别为花生四烯酸0.16 mM和ADP 0.33微米。正常富血小板血浆中花生四烯酸为0.56 mM，ADP为0.96µm。患者与正常人之间的差异有非常显著意义(P<；0.001)。白蛋白水平最低(-lt；2g/dl)的患者的血小板对花生四烯酸诱导聚集高度敏感。在4例患者富含血小板的血浆中加入纯化的白蛋白，使白蛋白水平恢复到正常范围，使花生四烯酸的阈值聚集浓度正常化。循环血浆白蛋白浓度的升高导致花生四烯酸的阈值聚集浓度正常化。肾病综合征患者的低血浆白蛋白浓度明显是其对花生四烯酸体外诱导的血小板聚集超敏的重要因素，并可能导致其血栓形成倾向。
The relationship between low levels of circulating plasma albumin and hyper-sensitivity to the induction of platelet aggregation by arachidonic acid, ADP or collagen was studied in 19 patients with nephrotic syndrome. Similar studies were done in 16 healthy volunteers. All patients had abnormally low or low normal levels of plasma albumin, a protein which may regulate platelet aggregation and prostaglandin synthesis. The mean threshold concentration necessary to induce aggregation in patients'' platelet-rich plasma was 0.16 mM for arachidonic acid and 0.33 .mu.m for ADP. Respective values for normal platelet rich plasma were 0.56 mM for arachidonic acid and 0.96 .mu.M for ADP. Differences between patients and normals were highly significant (P < 0.001). Patients who had the lowest albumin levels of (< 2 g/dl) had platelets which were highly sensitive to induction of aggregation by arachidonic acid. Addition of purified albumin to platelet-rich plasma of 4 patients, to raise the albumin level to the normal range, resulted in normalizing the threshold aggregating concentration to arachidonic acid. Elevation of the concentration of circulating plasma albumin resulted in normalization of the threshold aggregating concentration to arachidonic acid. The low plasma albumin concentration in patients with nephrotic syndrome is apparently an important factor in their hyper-sensitivity to platelet aggregation by arachidonic acid in vitro and could contribute to their thrombotic tendency.