肝硬化患者凝血4项指标与血小板参数检测的临床价值

目的:探讨肝硬化患者的凝血功能与血小板参数联合监测的临床意义.方法:对88例肝硬化患者的凝血酶时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白(FIB)、凝血酶时间(TT)等4项凝血指标和血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)等血小板参数进行测定,并与80例正常人进行对照.结果:与对照组相比,患者组 PT、TT、APTT 显著延长(P<0.01),差别有极显著性意义;FIB、PLT、PCT 明显下降(P<0.01),差别有极显著性意义;MPV、PD 高对照组(P<0.05),差别有显著性意义.随着肝硬化患者 Child-Pugh 评分的升高,PLT、PCT 明显下降,MPV、PDW 明显上升;Child-A、Child-B、Child-C 组间 PLT、PCT、MPV、PDW 相互比较,差异均具有显著意义(P<0.05).结论:凝血4项指标与血小板参数指标的联合监测,对临床判定肝硬化患者的肝功能损害程度和有无出血倾向有重要价值.     

乳腺癌手术前后凝血纤溶功能及血小板参数变化及意义

目的:探讨乳腺癌患者手术前后凝血纤溶功能及血小板参数的变化情况及其意义。方法:收取2014年2月至2016年2月间于我院进行手术的乳腺癌患者90例作为研究对象进行回顾性分析,对其手术前一天及手术后凝血纤溶功能及血小板参数进行比较,另选择同期于我院进行体检的35例健康女性作为对照。结果:乳腺癌组手术前凝血纤溶功能各指标均显著高于对照组,手术后纤维蛋白原(FIB)、D-二聚体(D-D)均较术前明显升高,凝血酶原时间(PT)、活化部分凝血酶时间(APTT)明显降低,差异有统计学意义(P0.05)。乳腺癌组手术前血小板参数均显著高于对照组,手术后血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)均较术前明显升高,差异有统计学意义(P0.05)。肿瘤分期为Ⅰ~Ⅱ期的患者PT、APTT、FIB及D-D变化幅度均小于Ⅲ期患者;无淋巴结转移的患者TT、APTT变化幅度小于有淋巴结转移的患者;HER-2受体阴性患者D-D变化幅度小于HER-2受体阳性患者,差异有统计学意义(P0.05)。肿瘤分期为Ⅰ~Ⅱ期的患者血小板计数(PLT)及MPV变化幅度小于Ⅲ期患者;HER-2受体阴性患者PLT及MPV变化幅度小于HER-2受体阳性患者,差异有统计学意义(P0.05)。结论:乳腺癌患者凝血纤溶功能及血小板参数均较健康女性有较大改变,且术后患者血液高凝状态更加明显,机体存在更高的血栓风险,应加强围手术期管理。     

不同化疗方案对非小细胞肺癌患者凝血纤溶功能及血小板参数的影响及其临床意义

目的:探讨不同化疗方案对非小细胞肺癌患者凝血纤溶功能及血小板参数的影响及临床意义。方法:回顾性分析2013年2月至2016年2月于我院进行治疗的96非小细胞肺癌患者的临床资料,按照化疗方案的不同分为TP组(50例)及GP组(46例),TP组患者给予多西他赛联合卡铂方案(TP方案)进行化疗,GP组患者给予吉西他滨联合卡铂方案(GP方案)进行化疗,另选择45例健康体检者作为对照组。比较三组治疗前者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、血浆纤维蛋白原含量(FIB)以及D-二聚体(D-dimer)、血小板数(PLT)、血小板比积(PCT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)以及大体积血小板比率(P-LCR)及TP组和GP组治疗后以上指标的差异。结果:TP组和GP组患者化疗前PT、APTT、TT、FIB、D-dimer、PLT、PCT、MPV、PDW以及P-LCR水平均明显高于对照组(P0.05),而TP组与GP组以上指标比较无显著差异(P0.05)。治疗后,TP组和GP组患者PT、APTT、TT、FIB、D-dimer、PLT、PCT、MPV、PDW以及P-LCR水平均较治疗前有所下降,且GP组TT明显长于TP组(P0.05),PLT、PCT明显低于TP组(P0.05)。结论:凝血纤溶功能及血小板参数对于评价不同化疗方案治疗非小细胞肺癌患者预后具有积极的临床价值,不同化疗方案选择对于患者凝血系统均具有一定的影响。     

氯吡格雷联合阿司匹林治疗老年冠心病的临床疗效观察

目的:探讨氯吡格雷联合阿司匹林治疗老年冠心病(CHD)的临床疗效和安全性。方法:60例老年CHD患者随机分为治疗组和对照组。对照组采用阿司匹林治疗,治疗组采用氯吡格雷联合阿司匹林治疗,治疗4周后观察血小板聚集率(PAG)和凝血功能。结果:治疗4周后,治疗组PAG显著下降,APTT显著上升,与治疗前和对照组比较均有显著性差异(P<0.05);两组治疗前后PT、PA变化差异无统计学意义(P>0.05)。两组均未出现不良反应。结论:阿斯匹林联合氯吡格雷治疗老年CHD患者,较单用阿斯匹林治疗更能有效地抑制血小板聚集和预防血栓形成,并能得到更好的临床疗效。     

尖吻蝮蛇毒无出血活性纤维蛋白溶解酶对动物凝血功能的影响

为探讨尖吻蝮蛇毒无出血活性纤维蛋白溶解酶 (NHFLE)对动物凝血功能的影响 ,作者应用家兔、大鼠作动物体内外实验观察 NHFLE对血小板聚集的影响及对凝血功能的影响 ,分别测定了纤维蛋白含量、全血凝固时间(CT)、活化的部分凝血酶原时间 (APTT)、凝血酶时间 (PT)和优球蛋白溶解时间 (ELT)、凝血酶时间 (TT)以及血小板聚集率等。结果无论是体外法还是体内法 ,尖吻蝮蛇毒 NHFLE都能明显延长 CT、 APTT、 PT、 TT,缩短 ELT的溶解时间 ,明显降低纤维蛋白原的含量 ,给药后 30 min纤维蛋白原降低最明显 ,但对血小板聚集均无抑制作…     

早期脓毒血症患者Gelsolin 与HS-1 蛋白检测及其意义

要目的：探讨脓毒血症患者血小板骨架蛋白Gelsolin和造血系细胞特异性蛋白(HS-1)及其和凝血功能的关系。方法：纳入脓毒 血症患者30 例和对照组健康人群30 例,用双抗体夹心法测定血浆中血小板骨架蛋白,用酶联免疫法测定血清中HS-1 蛋白含 量,采用免疫荧光观察血小板Gelsolin 蛋白的表达,分析Gelsolin、HS-1、血小板计数和凝血功能(PT、APTT)之间的关系。结果：对 照组Gelsolin 主要位于血小板胞浆内,观察组包浆内外及间质内均可见。观察组血小板骨架蛋白Gelsolin、HS-1 水平明显高于对 照组,差异均存在统计学意义(P<0.05)。观察组血小板计数、PT、APTT 水平均低于对照组,差异存在统计学意义(P <0.05)。Galsolin 和血小板计数呈负相关关系,相关系数r = -0.76 (P <0.05),HS-1和血小板计数间呈负相关关系相关系数r = - 0.69 (P<0.05)。结论： 早期脓毒血症患者血小板骨架蛋白Gelsolin 和HS-1表达水平明显升高,与脓毒血症患者血小板大量破坏有关。     

脓毒症患者炎性因子、凝血功能与APACHEⅡ评分和预后的关系

目的:研究脓毒症患者炎性因子、凝血功能与急性生理学和慢性健康状况Ⅱ(APACHEⅡ)评分和预后的关系。方法:选取2017年1月至2018年1月我院收治的脓毒症患者150例为脓毒症组,所有患者根据预后结果分为死亡组(n=49)和存活组(n=101),选择同期在我院住院的非脓毒症患者98例为非脓毒症组,比较脓毒症组与非脓毒症组患者炎性因子、凝血功能指标水平及APACHEⅡ评分,同时比较死亡组和存活组患者炎性因子、凝血功能指标水平及APACHEⅡ评分,并分析脓毒症患者APACHEⅡ评分与炎性因子、凝血功能指标的相关性。结果:脓毒症组患者降钙素原(PCT)、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)水平及APACHEⅡ评分均高于非脓毒症组,血小板计数(PLT)低于非脓毒症组(P0.05),两组C-反应蛋白(CRP)比较差异无统计学意义(P0.05)。死亡组患者PCT、APTT、PT水平及APACHEⅡ评分均高于存活组,PLT水平低于存活组(P0.05),两组CRP比较差异无统计学意义(P0.05)。经Spearman相关性分析结果显示,脓毒症患者APACHEⅡ评分与PCT、APTT、PT均呈正相关关系,与PLT呈负相关关系(P0.05),与CRP无相关性(P0.05)。结论:脓毒症患者PCT、APTT、PT水平明显上升,PLT水平明显下降,且均与患者的APACHEⅡ评分密切相关,临床可通过调节炎症因子水平及凝血功能指标从而改善患者的病情和预后。     

不同比例新鲜冰冻血浆对大量输血患者凝血功能的影响

目的:探讨不同比例输注新鲜冰冻血浆对大量输血患者凝血功能的影响。方法:回顾性分析本院2018年1月至2018年12月收治的123例大量输血患者的临床资料,依据所输注新鲜冰冻血浆与红细胞比例不同,将其分为低比例组(1:3)、中比例组(1:2)、高比例组(1:1),比较三组患者输血前后凝血功能、血小板计数及电解质变化。结果:输血后,三组患者FIB较输血前明显降低,而PT、APTT较输血前显著升高(P0.05),高比例组PT和APTT明显低于中比例组和低比例组,FIB、血小板均高于中比例组和低比例组(P0.05),电解质水平优于低比例组和中比例组(P0.05)。结论:在大量输血时,提高血浆与红细胞比例有利于改善大量输血患者凝血功能障碍,减少电解质紊乱。     

血栓弹力图检测在卵巢过度刺激综合征中的应用

目的:研究血栓弹力图在卵巢过度刺激综合征(Ovarian Hyperstimulation Syndrome,OHSS)患者血凝块形成评价中的应用及临床意义。方法:将35例接受胚胎移植治疗后发生OHSS患者及21例同期治疗未发生OHSS患者,进行血栓弹力图(Thromboelastography,TEG)检测,同时收集常规凝血参数(凝血酶原时间(Prothrombin time,PT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)、纤维蛋白原(Fibrinogen,FIB)等)。分析OHSS患者与对照患者凝血和TEG各指标的差异,以及OHSS患者治疗前后TEG各指标的差异。结果:(1)OHSS患者PT时间明显高于对照组,FIB水平明显低于对照组,但APTT时间无明显区别(P=0.112);(2)TEG检测OHSS组的血凝综合指数明显高于对照组(3.6±0.7:0.8±0.5);(3)治疗后,OHSS患者血凝综合指数2.8±0.9,较治疗前明显下降(P0.01)。结论:TEG检测可用于OHSS患者凝血功能的评估。     

血栓弹力图评价心力衰竭合并肺部感染患者凝血状态的价值研究

摘要 目的：探讨血栓弹力图（TEG）评价心力衰竭合并肺部感染患者凝血状态的价值。方法：选取来我院就诊的心力衰竭合并肺部感染患者70例作为研究组,同时选取非心力衰竭合并肺部感染并且无凝血相关疾病患者70例作为对照组。检测常规凝血相关指标、血小板指标以及TEG相关参数,分析TEG相关参数与常规凝血检查指标和血小板指标之间的相关性。以超声检查血栓是否发生为判断标准,对常规凝血检查指标、血小板指标和TEG参数分别进行回归分析,得到回归分析方程后绘制ROC曲线,比较TEG、常规凝血检查和血小板指标评价心力衰竭合并肺部感染患者凝血状态的效能。结果：研究组PT、TT和APTT、PLT水平较对照组显著降低,FIB和D-D较对照组显著升高,差异均具有统计学意义（P<0.05）。研究组中R值、K值较对照组显著下调,而α角和MA值较对照组显著上调,差异具有统计学意义（P<0.05）。R值与PT、 TT以及APTT呈正相关（P<0.05）;K值与FIB呈负相关,与APTT、PLT呈正相关（P<0.05）;α角与FIB、D-D呈正相关,与PLT呈负相关（P<0.05）;MA值与PT、 PLT呈负相关,与FIB呈正相关（P<0.05）。ROC曲线显示,APTT、 D-D、PLT诊断血栓的曲线下面积、特异度和灵敏度均小于TEG。结论：相比于传统常规凝血检查和血小板检查,TEG可以更加全面反映心力衰竭合并肺部感染患者的凝血状态,快速准确地判断心力衰竭合并肺部感染患者是否发生血栓。     

Anti-thrombosis effect of diosgenin extract from Dioscorea zingiberensis C.H. Wright in vitro and in vivo

Thrombus formation in blood vessel plays an important role in the pathogenesis and progression of atherosclerosis and cardiovascular diseases. Extract of Dioscorea zingiberensis C.H. Wright (D. zingiberensis) is demonstrated to posses activities for curing cardiovascular diseases such as coronary heart disease and angina pectoris. However, there were few studies on anti-thrombosis activity of it. We investigated the anti-thrombosis effect of diosgenin from D. zingiberensis (Dio) in vitro and in vivo on inferior vena cava ligation thrombosis rat model and pulmonary thrombosis mice model. We evaluated the protective effect of Dio by measuring the platelet aggregation, activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT) and the venous thrombosis in rats and the bleeding time, clotting time and protection rate in mice. Results showed that Dio inhibited platelet aggregation, thrombosis and prolonged APTT, PT and TT in rats in a dose-dependent manner. They also prolonged the bleeding time, clotting time and increased protection rate in mice in a dose-dependent manner. Taken together, these findings suggested that Dio which contained 95% diosgenin had anti-thrombosis activity. Dio executives the anti-thrombosis activity through improving the anticoagulation function, inhibiting platelet aggregation and thrombosis.     

Presence of factors that activate platelet aggregation in mitral stenotic patients' plasma

BACKGROUND: Although the association between mitral stenosis (MS) and increased coagulation activity is well recognized, it is unclear whether enhanced coagulation remains localized in the left atrium or whether this represents a systemic problem. To assess systemic coagulation parameters and changes in platelet aggregation, we measured fibrinogen levels and performed in vitro platelet function tests in plasma obtained from mitral stenotic patients' and from healthy control subjects' peripheral venous blood. METHODS: Sixteen newly diagnosed patients with rheumatic MS (Group P) and 16 healthy subjects (Group N) were enrolled in the study. Platelet-equalized plasma samples were evaluated to determine in vitro platelet function, using adenosine diphosphate (ADP), collagen and epinephrine in an automated aggregometer. In vitro platelet function tests in group N were performed twice, with and without plasma obtained from group P. RESULTS: There were no significant differences between the groups with respect to demographic variables. Peripheral venous fibrinogen levels in Group P were not significantly different from those in Group N. Adenosine diphosphate, epinephrine and collagen-induced platelet aggregation ratios were significantly higher in Group P than in Group N. When plasma obtained from Group P was added to Group N subjects' platelets, ADP and collagen-induced, but not epinephrine-induced, aggregation ratios were significantly increased compared to baseline levels in Group N. CONCLUSION: Platelet aggregation is increased in patients with MS, while fibrinogen levels remain similar to controls. We conclude that mitral stenotic patients exhibit increased systemic coagulation activity and that plasma extracted from these patients may contain some transferable factors that activate platelet aggregation.     

Anti-thrombosis effect of diosgenyl saponins in vitro and in vivo

Thrombosis in coronary or cerebral arteries is the major cause of morbidity and mortality worldwide. Diosgenin and total steroidal saponins extracted from the rhizome of Dioscorea zingiberensis C.H. Wright are demonstrated to have anti-thrombotic activity. However, few studies describe the anti-thrombotic activity of the diosgenyl saponin monomer. In the present study, a simple and convenient method for the preparation of a new disaccharide saponin, diosgenyl β-d-galactopyranosyl-(1 → 4)-β-d-glucopyranoside (3), is described. We evaluated the anti-thrombotic effects of diosgenin and four diosgenyl saponins by measuring the bleeding time; the results showed that compound 3 exhibits outstanding efficiency in prolonging the bleeding time. Furthermore, we assessed whether compound 3 could alter platelet aggregation in vitro and in vivo. In addition, activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), coagulation factors and protection rate in mice were measured to evaluate the anti-thrombotic effect of compound 3. The results show that compound 3 inhibited platelet aggregation, prolonged APTT, inhibited factor VIII activities in rats, and increased the protection rate in mice in a dose-dependent manner. Taken together, these findings suggested that diosgenyl saponins, especially compound 3, had anti-thrombotic activity. It may execute anti-thrombotic activity through inhibiting factor VIII activities and platelet aggregation.     

Small aggregates of platelets can be detected sensitively by a flow cytometer equipped with an imaging device: mechanisms of epinephrine-induced aggregation and antiplatelet effects of beraprost

BACKGROUND: Although cross-talks between platelets and other blood cells are important in vivo, laboratory platelet aggregation tests have been performed mainly with the use of platelet-rich plasma (PRP) as samples. Methods that enable an efficient and sensitive detection of platelet aggregates in whole blood are being developed. METHODS: A flow cytometer equipped with an imaging device, the flow imaging cytometer 2 (FIC2), was used to detect platelet aggregates in whole blood. RESULTS: The FIC2 provides a resolution that is high enough to differentiate platelet aggregates from single platelets or other blood cells. Epinephrine elicited platelet aggregate formation in hirudin plus argatroban-treated whole blood, but not in PRP. The reconstitution study revealed that a small amount of adenosine diphosphate (ADP) from erythrocytes may play an important role in epinephrine-induced platelet aggregation (in whole blood), through mediation of P2Y1 receptors. When the inhibitory effect of beraprost, an antiplatelet agent, on platelet aggregation was assessed, analysis of whole blood samples with FIC2 proved to be the most sensitive among the methods available. CONCLUSIONS: FIC2 is a promising device for detection of platelet aggregates in whole blood, with wide basic and clinical applications.     

组织多普勒成像对射血分数正常的心衰患者左心功能评价

目的:探讨组织多普勒成像(TDI)技术评价射血分数正常的心衰患者左室长轴功能特点。方法:选取30名健康人(Ⅰ组)、EF>50%的心衰患者30名(Ⅱ组)和EF<50%的心衰患者30名(Ⅲ组)作为研究对象,采用TDI在二尖瓣环室间隔(ivs)、侧壁(l)、前壁(a)、后壁(p)、下壁(d)测量其Sm、DSm、IVCTm、TSm、Em、Am、IVRTm、TEm等指标。结果:Ⅰ组、Ⅱ组、Ⅲ组DSm、Sm逐渐减低,(P<0.05);而IVCTm、TSm逐渐升高(P<0.05);IVRTm、TEm在Ⅰ组、Ⅲ组、Ⅱ组逐渐升高(P<0.05);DSm及TEm在诊断EF>50%心衰患者心功能的指标中ROC曲线下面积最大,同样DSp及TEp在五个位点中ROC曲线下面积最大。结论:射血分数正常的心衰患者存在收缩减低;DSm及TEm是诊断EF>50%心衰患者心功能比较有效的指标;后壁是诊断的最佳位点。     

阿加曲班对MCAO大鼠不同时间点血小板功能的影响

建立大脑中动脉闭塞(model of middle cerebral artery occlusion,MCAO)大鼠模型,研究阿加曲班对大鼠不同时间脑缺血再灌注损伤血小板功能的影响。将120只健康雄性SD大鼠随机分为假手术组(Sham)、模型组(Model)和阿加曲班给药组(Argatroban),其中Argatroban组分为4组:Argatroban+30 min组、Argatroban+1 h组、Argatroban+3 h组和Argatroban+7 h组,Sham组和Model组40只,其余各组每组10只。线栓法制备大鼠MCAO模型,术中输注Argatroban,剂量为0.3μg·kg^-1·min^-1,完成手术前5 min停止输注。手术完成后,Sham组和Model组分别于术后30 min、1 h、3 h和7 h处死10只取样;Argatroban给药组5个时间点处死取样。检测大鼠血浆血细胞数量,并计数骨髓有核细胞数的变化。采用流式细胞仪检测血小板-白细胞聚集体(platelet-leukocyte aggregates,PLA)表达水平,观察活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、血小板计数变化,ELISA检测血浆D-二聚体和TAT。结果显示,与Sham组相比,Model组大鼠的红细胞(RBC)、白细胞(WBC)、血红蛋白含量(HGB)和中性粒细胞(GR)数都显著升高(p<0.05),且与给药组没有统计学差异。Sham组、Model组和Argatroban给药组的骨髓有核细胞数也没有统计学差异。与Sham组相比,Model组PLA表达水平极显著升高(p<0.01),Argatroban+30 min组PLA表达水平却低于Sham组,但没有统计学差异,Argatroban+1 h组高于Sham组和Argatroban+30 min组(p<0.05),Argatroban+3 h组和Argatroban+7 h组高于Argatroban+1 h组低于Sham组。术后各组的血小板计数均高于Sham组(p<0.05),Argatroban各组的血小板计数要低于Model组(p<0.05),并在30 min时达到最低,30 min以后血小板升高,但是1 h以后血小板不再升高,趋于稳定。Argatroban各组PT和APTT虽略有降低,但是与Sham组和Model组并没有统计学差异。造模后各组TAT、D-二聚体水平显著升高,Argatroban各组TAT水平较模型组明显降低(p<0.05),Argatroban+30 min组水平最低。MCAO模型大鼠血液呈现高凝状态,凝血功能和纤维蛋白溶解功能亢进,血小板活化增强,阿加曲班可对此起到改善作用。     

Platelet and neutrophil responses to Gram positive pathogens in patients with bacteremic infection

Background

Many Gram-positive pathogens aggregate and activate platelets in vitro and this has been proposed to contribute to virulence. Platelets can also form complexes with neutrophils but little is however known about platelet and platelet-neutrophil responses in bacterial infection.

Methodology/Principal Findings

We added isolates of Gram-positive bacteria from 38 patients with a bacteremic infection to blood drawn from the same patient. Aggregometry and flow cytometry were used to assess platelet aggregation and to quantify activation of platelets, neutrophils, and platelet-neutrophils complexes (PNCs) induced by the bacteria. Fifteen healthy persons served as controls. Most isolates of Staphylococcus aureus, beta hemolytic streptococci, and Enterococcus faecalis induced aggregation of platelets from their respective hosts, whereas pneumococci failed to do so. S. aureus isolates induced platelet aggregation more rapidly in patients than in controls, whereas platelet activation by S. aureus was lower in patients than in controls. PNCs were more abundant in baseline samples from patients than in healthy controls and most bacterial isolates induced additional PNC formation and neutrophil activation.

Conclusion/Significance

We have demonstrated for the first time that bacteria isolated from patients with Gram-positive bacteremia can induce platelet activation and aggregation, PNC formation, and neutrophil activation in the same infected host. This underlines the significance of these interactions during infection, which could be a target for future therapies in sepsis.     

Plasma very-low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein oxidative modification induces procoagulant profiles in endogenous hypertriglyceridemia

This study was to investigate whether oxidatively modified lipoproteins were associated with changes of pro- and anticoagulant profiles in hypertriglyceridemic subjects. Plasma VLDL, LDL, and HDL were isolated with the one-step density gradient ultracentrifugation method. The oxidation of the lipoproteins was identified. Prothrombin time (PT) and activated partial thrombplastin time (APTT), tissue plasminogen activator and plasminogen activator inhibitor-1, and platelet aggregation rate were determined with a reaction system consisting of mixed fresh normal plasma, in endogenous hypertriglyceridemic (HTG) patients, in in vitro modified lipoproteins from a normolipidemic donor, and in experimental rats. The results indicated that oxVLDL, oxLDL, and oxHDL occurred in the plasma of HTG patients. Compared with the control group, PT and APTT, incubated with plasma VLDL, LDL, or HDL from HTG patients, respectively, were significantly reduced, while platelet maximal aggregation rates were significantly higher (P < 0.05-0.01). Similar procoagulant profiles were observed in in vitro modified lipoprotein components and in rats with intrinsic hypertriglyceridemia as well. These results support our previous finding that LDL, VLDL, and HDL were all oxidatively modified in vivo in the subjects with HTG, and suggest that procoagulation state may result from the abnormal plasma lipoprotein oxidative modification in vivo.     

Leptin Does Not Play a Major Role in Platelet Aggregation in Obesity and Leptin Deficiency

Objective: A recent study suggested that high concentrations of leptin enhance platelet aggregations. Therefore, the aim of this study was to investigate whether platelet aggregation is altered in patients with leptin gene mutations compared with obese subjects or controls. Research Methods and Procedures: Four men (one homozygous man and his three heterozygous brothers) carrying a leptin gene mutation; 20 age‐matched, healthy, unrelated men; and 18 age‐matched obese men were enrolled in the study. Adenosine diphosphate (ADP)‐, collagen‐, and epinephrine‐induced platelet aggregation were evaluated in all individuals. Results: Our results show that patients with the leptin gene mutation (both the homozygous and heterozygous patients) had significantly higher ADP‐induced (78.3 ± 3.4% vs. 57.9 ± 9.3%, p = 0.001), collagen‐induced (78.1 ± 2.9% vs. 56.7 ± 9.3%, p = 0.007), and epinephrine‐induced (76.5 ± 9.2% vs. 59.5 ± 7.70%, p = 0.003) platelet aggregation compared with controls. However, ADP‐, collagen‐, or epinephrine‐induced platelet aggregations were similar to those in obese patients. Platelet aggregation responses to a combination of pretreatment with leptin at concentrations of 20, 50, 100, or 500 ng/mL for 5 minutes and ADP at concentrations of 2 μmol/liter also were evaluated. However, we did not find significant increases in platelet aggregation even at high concentrations of leptin (100 or 500 ng/mL) in leptin‐deficient patients, obese subjects, or controls. Discussion: Our data show that similar to findings in obese humans, homozygous or heterozygous leptin deficiency is associated with increased platelet aggregation compared with controls, and that higher concentrations of leptin do not increase platelet aggregation.     

游泳训练对高血压大鼠血压及血栓前状态分子的影响*

目的: 观察10周游泳训练对自发性高血压大鼠(SHR)血压及血栓前状态分子血管性血友病因子(vWF)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物(PAI-1)的影响。方法: 选取10周龄雄性SHR(18只),随机分为对照组(8只)和训练组(10只),SHR训练组进行5次/周,每次60 min,共持续10周的无负重游泳训练,期间每2周测定大鼠血压。10周训练后,分别测定两组SHR血小板聚集率、血浆vWF、t-PA和PAI-1。结果: 与对照组相比,训练组SHR经4周游泳训练后,血压显著下降(P＜0.05),经10周游泳训练后,血压、血小板聚集率、血浆vWF水平、PAI-1活性显著降低(P＜0.01),血浆t-PA活性显著提高(P＜0.01)。结论: 适宜游泳训练能有效平抑(或改善)SHR的血压,坚持4周训练即可产生显著的作用,还可明显改善SHR血栓前状态,预防高血压血栓性并发症。