血小板功能随着肝硬化和门性高血压的严重程度增加而下降-一项前性研究
Ksenia Brusilovskaya1,2,3, Benedikt Silvester Hofer1,2,3, Benedikt Simbrunner1,2,3,4
1Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Thrombosis and haemostasis
|July 30, 2023
概括
晚期肝硬化和门性高血压患者的血小板激活和反应能力下降. 这种降低的血小板功能可能与较低的抗素III水平有关.
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
- 血栓形成研究研究
背景情况:
- 肝硬化会增加出血和血栓形成的风险.
- 血小板激活是血液静止和血栓形成的关键因素.
- 了解肝硬化中血小板的行为对于管理患者的结果至关重要.
研究的目的:
- 在不同Child-Pugh阶段 (CPS) 和门高血压 (PH) 严重程度的肝硬化患者中调查血小板激活.
- 评估血小板激活标志物的表达,以应对各种激动剂.
- 为了将血小板激活与临床参数 (如PH严重程度和抗素III水平) 相关联起来.
主要方法:
- 对110名肝硬化患者进行前性研究.
- 查尔德-普格阶段 (CPS) 和肝静脉压梯度 (HVPG) 的评估.
- 血小板P-选择素和活性糖蛋白 (GP) IIb/IIIa在激动剂 (PAR-1, PAR-4,上腺素, LPS) 刺激前后表达的流细胞计测量.
主要成果:
- 血小板数量随着PH严重程度的增加而减少.
- 降低P-选择因和激活GPIIb/IIIa表达,以响应PAR-1和PAR-4激动剂在儿童皮格B/C患者和那些HVPG≥20mmHg.
- 在CPS-C患者中降低了与上腺素/LPS的P-选择因表达;在CPS-B/C患者中降低了这些激动因子的激活GPIIb/IIIa.
- 较低的抗素III水平与通过PAR-1和PAR-4减少的血小板激活相关.
结论:
- 随着肝硬化和门高血压的严重程度的进展,血小板的响应能力会下降.
- 在严重肝硬化和PH中血小板活化减少可能与较低的抗素III水平有关.
- 这些发现突出了肝硬化中血小板功能的改变及其潜在的临床影响.
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