2017 年第 10 期 第 12 卷

血小板膜糖蛋白CD62p在肝素诱导的血小板减少症患者中的表达和临床意义

Expression and clinical significance of platelet membrane glycoprotein CD62p in heparin-induced thrombocytopenia

作者：张炳昌李化会刘丰海王术国

英文作者：Zhang Bingchang Li Huahui Liu Fenghai Wang Shuguo

单位：250000济南，山东大学附属省立医院检验医学部（张炳昌）；266071山东省青岛市市立医院检验科（李化会、刘丰海、王术国)

英文单位：Department of Laboratory Medicine Shandong Provincial Hospital Affiliated to Shandong University Jinan 250000 China （Zhang BC）; Department of Laboratory Medicine Qingdao Municipal Hospital Shandong Province Qingdao 266071 China（Li HH Liu FH Wang SG）

关键词：血小板减少；肝素；CD62p

英文关键词：Thrombocytopenia;Heparin;CD62p

• 摘要：

• 目的 探讨血小板膜糖蛋白CD62p在肝素诱导的血小板减少症（HIT）中的表达和临床意义。方法 选取2011年11月至2014年5月在山东省青岛市市立医院住院并接受普通肝素治疗的心血管疾病患者550例。根据患者肝素/血小板因子4复合物（HPF4）抗体产生和血小板减少情况分为2个组，其中产生HPF4抗体同时伴有HIT为临床HIT组，其余患者为非HIT组。同期选取30例门诊健康体检者作为正常对照组。3组受试者于临床HIT组使用肝素后1、3、5 d以及停用肝素后1周同期4个时间点采用流式细胞仪测定静脉血CD62p阳性率和HPF4阳性率，组间做比较。结果 550例患者中共检出HPF4抗体阳性患者95例，总阳性率为17.3%。应用肝素1、3、5 d后，临床HIT组的CD62p阳性率分别为（20.62±4.48）%、（24.62±5.88）%、（25.62±3.65）%，明显高于非HIT组［（2.15± 0.55）%、（1.93±0.65）%、（1.99±0.99）%］及正常对照组［（1.95±0.45）%、（1.85±0.23）%、（1.72±0.69）%］，差异均有统计学意义(均P<0.05)；停用肝素1周后临床HIT组CD62p阳性率明显下降，与正常对照组差异无统计学意义（P>0.05)。结论 CD62p表达情况与HIT的发生、发展密切相关，对HIT的诊断有一定价值。

• Objective To explore expression and clinical significance of platelet membrane glycoprotein CD62p in heparin-induced thrombocytopenia（HIT）. Methods Totally 550 patients with cardiovascular diseases who were treated with unfractionated heparin from November 2011 to May 2014 at Qingdao Municipal Hospital in Shandong Province were enrolled. Patients with positive heparin/platelet factor 4（HPF4） antibody and thrombocytopenia were included in HIT group; other patients were included in non-HIT group. Thirty healthy outpatients were selected as normal control group. Expression rate of CD62p and positive rate of HPF4 were tested by flow cytometry at 1, 3, 5 d after use of heparin and 1 week after withdrawal of heparin in HIT group. Results Among 550 patients, 95 patients were detected positive HPF4 antibody; the positive rate was 17.3%. Expression rates of CD62p at 1, 3, 5 d after use of heparin in HIT group were significantly higher than those in non-HIT group and normal control group［（20.62±4.48）% vs （2.15± 0.55）%,（1.95±0.45）%; （24.62±5.88）% vs （1.93±0.65）%, （1.85±0.23）%; （25.62±3.65）% vs （1.99±0.99）%, （1.72±0.69）%］（P＜0.05）. The expression rate of CD62p in HIT group significantly decreased at 1 week after withdrawal of heparin and showed no significant difference compared to that in normal control group（P＞0.05）. Conclusion Expression of CD62p is valuable for diagnosis of HIT.