肝硬化门静脉血栓形成患者血小板活化上调。

IF 5 2区 医学 Q1 HEMATOLOGY
Thrombosis and haemostasis Pub Date : 2024-08-01 Epub Date: 2023-10-12 DOI:10.1055/a-2190-8705
Fazhi Zhao, Jingnuo Ding, Juanjuan Cui, Mingqing Zhu, Weifeng Zhao
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引用次数: 0

摘要

目的:血小板功能的改变在血栓形成中起着关键作用。本研究旨在探讨肝硬化门静脉血栓形成(PVT)过程中血小板功能的改变。方法:招募2021年10月至2023年4月期间入院的肝硬化患者,并将其分为PVT组和非PVT组。流式细胞术检测CD62p、CD63、单核细胞-血小板聚集物(MPAs)、中性粒细胞-血小板聚集体(NPAs)和vWF-Ag的表达,以评估血小板活化和粘附功能。结果:共有145名受试者参加了我们的研究,其中包括60名肝硬化PVT患者、60名肝硬化非PVT患者和25名健康志愿者。PVT组CD41+CD62p+和CD41+CD63+血小板表达较非PVT组显著升高(P<0.05),亚组分析表明,CD62p和CD63的平均荧光强度(MFI)与门脉高压相关并发症有关(P<0.01),CD41+CD62p+和CD41+CD63+血小板及MPAs和NPAs在脾切除组中高表达(P<0.05),血小板计数也与MPAs(r=0.556,P<0.001)和NPAs(r=0.467,P<001)相关。肝硬化PVT患者死亡率较高,更容易出现门静脉高压相关并发症(P<0.05),提示活化的血小板可能参与肝硬化患者PVT的形成。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Platelet Activation is Upregulated in Cirrhotic Patients with Portal Vein Thrombosis.

Objective:  Platelet plays a key role in thrombosis formation, especially that the alteration of platelet function may influence the thrombosis development. This study aimed to investigate platelet function alterations in the formation of portal vein thrombosis (PVT) in cirrhosis.

Methods:  Cirrhotic patients admitted to The First Affiliated Hospital of Soochow University between October 2021 and April 2023 were recruited and divided into PVT and non-PVT groups according to radiological results. Clinical parameters and prognosis were also collected and assessed to identify potential risk factors. Flow cytometry was used to detect the expression of CD62p, CD63, monocyte-platelet aggregates (MPAs), neutrophil-platelet aggregates (NPAs), and von Willebrand factor antigen (vWF-Ag) to evaluate platelet activation and adhesion function.

Results:  A total of 145 subjects were enrolled in our study including 60 cirrhotic PVT patients, 60 cirrhotic non-PVT patients, and 25 healthy volunteers. Multivariate analysis suggested that esophageal gastric varices, splenectomy, and D-dimer were independent risk factors for PVT pathogenesis in cirrhosis. The vWF-Ag expression level was reduced in the PVT group compared with the non-PVT group (p = 0.046) but was not an independent risk factor for PVT formation pathogenesis. The expression of CD41+CD62p+ and CD41+CD63+ platelets in the PVT group was significantly elevated compared with that in the non-PVT group (p < 0.05). There were no significant differences in MPAs and NPAs between the two cirrhotic groups. Subgroup analysis showed that the mean fluorescence intensity (MFI) of CD62p and CD63 was associated with portal hypertension-related complications (p = 0.008, p < 0.001), and CD63 MFI was significantly associated with thrombosis burden (p = 0.019). CD41+CD62p+ and CD41+CD63+ platelets as well as MPAs and NPAs were highly expressed in the splenectomy group compared with those in the nonsplenectomy group in cirrhotic patients (p < 0.05). Positive correlations were found between CD62p MFI and CD63 MFI, MPAs and NPAs (r = 0.642, p < 0.001; r = 0.378, p = 0.003; r = 0.430, p < 0.001). In addition, platelet counts were also correlated with MPAs (r = 0.556, p < 0.001) and NPAs (r = 0.467, p < 0.001). Cirrhotic patients with PVT had higher mortality and were more likely to experience portal hypertension-related complications in the prognostic analysis (p < 0.05).

Conclusion:  Highly activated platelet function exists in patients with cirrhosis, and platelet activation was elevated during PVT formation, suggesting that activated platelets may participate in the formation of PVT in patients with cirrhosis.

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来源期刊
Thrombosis and haemostasis
Thrombosis and haemostasis 医学-外周血管病
CiteScore
11.90
自引率
9.00%
发文量
140
审稿时长
1 months
期刊介绍: Thrombosis and Haemostasis publishes reports on basic, translational and clinical research dedicated to novel results and highest quality in any area of thrombosis and haemostasis, vascular biology and medicine, inflammation and infection, platelet and leukocyte biology, from genetic, molecular & cellular studies, diagnostic, therapeutic & preventative studies to high-level translational and clinical research. The journal provides position and guideline papers, state-of-the-art papers, expert analysis and commentaries, and dedicated theme issues covering recent developments and key topics in the field.
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