title: [Relative analysis of platelet activation with bleeding risk in patients with primary immune thrombocytopenia].
abstract: Objective:To study the relationship between platelet activation and the degree of bleeding in patients with primary immune thrombocytopenia (ITP) .Methods:43 patients with ITP were assessed based on ITP-BAT bleeding grading system. Platelet membrane glycoproteins (GP) Ⅰb, GPⅡb/Ⅲa and P-selectin expression were detected by flow cytometry analysis with and without adenosine diphosphate (ADP) stimulation. Association of platelet activation with platelet count, immature platelet fraction (IPF) , bleeding severity were evaluated.Results:GPⅡb/Ⅲa and P-selection expressions on unstimulated platelet in ITP patients were higher than those in healthy controls (65.69±10.73vs7.16±0.99,t=4.130,P<0.001; 15.43±1.41vs12.55±1.03,t=2.070,P=0.043, respectively) , and GPⅠb expression was lower than that in healthy controls (240.11±24.93vs295.11±22.15,t=2.417,P=0.020) . Comparatively to healthy individuals, following ADP stimulation, GPⅡb/Ⅲa expression in ITP patients increased (133.96±12.17vs39.67±4.99,t=5.256,P<0.001) , whereas GPⅠb and P-selection expressions decreased (37.09±3.94vs109.77±23.66,t=3.901,P<0.001; 149.06±19.14vs205.73±21.00,t=2.070,P=0.043, respectively) . ADP-stimulated GPⅠb, ADP-stimulated and unstimulated P-selection, proportion of GPⅠb, P-selection levels with/without ADP stimulation were significantly associated with platelet counts (P<0.05) . ADP-stimulated P-selection and proportion of P-selection levels with/without ADP stimulation were significantly associated with IPF (P<0.05) . There were significant differences in the expressions of unstimulated P-selection, ADP-stimulated P-selection, ADP-stimulated GPⅠb stratified by bleeding grades (P<0.05) . The ratios of P-selection, GPⅡb/Ⅲa and GPⅠb with/without ADP stimulation in ITP patients were significantly different among various bleeding grades (P<0.05) . Higher proportion of GPⅠb with/without ADP stimulation was associated with higher risk of bleeding (OR=3.05,P=0.011) . Lower proportion of GPⅡb/Ⅲa and P-selection with/without ADP was associated with higher risk of bleeding (OR=0.32,P=0.023;OR=0.04,P=0.006, respectively) .Conclusion:Platelet activation index could accurately assess the degree of bleeding in patients with ITP, and also be used as the observation index and reference index for treatment.
authors.affiliation: Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: M E
authors.initials: ME
authors.lastname: Lyu
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: C C
authors.initials: CC
authors.lastname: Lyu
authors.forename: W J
authors.initials: WJ
authors.lastname: Liu
authors.forename: Y
authors.initials: Y
authors.lastname: Guan
authors.forename: S X
authors.initials: SX
authors.lastname: Wang
authors.forename: R C
authors.initials: RC
authors.lastname: Yang
mesh_terms: D001792:Blood Platelets; D005434:Flow Cytometry; D006470:Hemorrhage; D006801:Humans; D015470:Leukemia, Myeloid, Acute; D019007:P-Selectin; D015539:Platelet Activation; D010976:Platelet Count; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019038:Platelet Glycoprotein GPIb-IX Complex; D016553:Purpura, Thrombocytopenic, Idiopathic
chemical_list: D019007:P-Selectin; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019038:Platelet Glycoprotein GPIb-IX Complex; C546937:SELP protein, human
keywords: Hemorrhage; P-selectin; Platelet activation; Platelet membrane glycoprotein; Thrombocytopenia