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降低血小板聚合在患有脱补偿性肝硬化和TIPS植入型肝硬化患者
Asala Nassar1,2, Jan Patrick Huber1, Daniela Stallmann2
1Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, D-79106 Freiburg, Germany.
Biomedicines
|July 29, 2023
概括
肝硬化患者的血小板聚合受损,这种情况在经内肝脏移植系统 (TIPS) 植入后继续存在. 这表明抗血小板治疗可能无法有效预防TIPS血栓形成.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 血液学 血液学 血液学
- 干预心脏病学 干预心脏病学
背景情况:
- 跨内肝移植系统 (TIPS) 植入是不补偿性肝硬化中门高血压的关键治疗方法.
- TIPS血栓形成可以导致复发的门高血压,但血小板和抗血小板治疗的作用尚不清楚.
研究的目的:
- 在TIPS植入之前和之后,研究肝硬化患者的血小板功能.
- 评估抗血小板治疗在预防TIPS血栓形成方面的必要性和潜在有效性.
主要方法:
- 全血阻抗聚合计 (WBIA) 和光传导聚合计 (LTA) 用于测试血小板聚合.
- 流细胞计评估了血小板激活标记物 (P-selectin,GPIIb/IIIa) 和血小板中性粒细胞复合体 (PNCs).
- 血小板功能分析了来自患者和健康对照的外周和门静脉血液样本在不同的时间点.
主要成果:
- 与健康对照组相比,肝硬化患者表现出抗激素诱导的血小板聚合减少.
- 在TIPS植入后,血小板聚合缺陷仍然存在.
- 虽然PNC在患者中较高,但特定激活标志物反应有所不同,PNC形成在不同组之间没有显著差异.
结论:
- 缺乏补偿的肝硬化患者具有固有的体外血小板聚合缺陷.
- 这些缺陷在TIPS植入后仍然存在,质疑抗血小板治疗用于预防TIPS血栓的常规使用.
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