冠心病血瘀证患者血小板超微结构和功能的研究

在电镜下对冠心病血瘀证患者的血小板作超微结构和功能的多项指标研究结果:患者大型血小板比例增高,易于变形,糖萼增厚,膜的异常运动增多,糖原增多。对 ADP 敏感;聚集功能增强,细胞膜融合发生较早,释放反应活跃,吞噬能力降低,腺苷酸环化酶活性降低;对钙的反应增强;丙二醛含量增高。这些异常表现与血瘀程度基本呈一致关系,故认为血小板的变化是冠心病血瘀证中的一种实质性表现,与血小板形态、功能密切相关。

英文摘要:

36 healthy persons(as control g-roup)and coronary heart disease(CHD,8 stable angina pectoris, 8 unstable angina pectoris,20 OMI,28 AMI)with three different degrees of blood-stasis,patients’ platelets were studied ultrastructurally and functionally on many items.Under transmission electron microscope(TEM)it were found that the proportions of large platelet were 6.4±0.20 in group Ⅰ (control group),13.5±0.52 in group Ⅱa(CHD with mild blood-stasis):17.7±0.45 in group Ⅱb(CHD with moderate blood-stasis),and 27.5±0.38 in group Ⅱc(CHD)with severe blood-stasis);platelet with thicker glycocalyx in each group were 6.7±0.21,66.7±0.71,80.2±0.47 and 83.9±0.32 respectively;the latex particle phagocytic rate by platelets were 67.7±0.39,40.3±0.58,32.9±0.71 and 10.7±0.26 respectively;platelets with increased glycogen particles were 4.2±0.17,41.2±0.74,57.1±0.53 and 52.0±0.42 respectively.Between groups,the most figures presented above had statistic differences (P<0.05,P<0.01).TEM and SEM observation showed that in patients group,platelet was easier to change its shape,to aggregate and adhere,was more sensitive to ADP,more mutual transformation in intracellular membrane system,and had increased ability to uptake calcium ion and respond to it. Fusion of platelet memberane in aggregating was earlier,release reaction was more active which caused reducing the intracellular granule.TEM histochemistry study and malonaldehyde(MDA) estimation demonstrated platelet adenyl cyclase(CA)activity decreased anal MDA content increased. The study showed that the more patients’platelets were in activated state,the lower were some of their functions(such as phagocytosis and CA activity).These abnormality related to the severity of blood-stasis but did not to the type of CHD.The result showed that blood-stasis was one of the essences of CHD.The morphological and functional abnormality of platelet were some of the basis of blood stasis symptom-complex.

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