Clincial Study Of Platelet Thrombin Receptors In Chronic Haemodialysis Patients And Clincial Effect Of Traditional Chinese Medicine

Part one Levels of main platelet thrombin receptors in chronic haemodialysis patientsObjective:To investigate the expression of platelet membrane receptors proteinase activated receptor-1(PARl), proteinase activated receptor-4(PAR4) and glycoprotein Iba (GPIba) in patients on chronic haemodialysis (HD).Methods:Flow cytomery was used to assess the expression of PARl, PAR4and GPIba levels on the platelet surface. Platelet reactivity was assessed by ADP-stimulated aggregation. The results were expressed as the maximal platelet aggregation rate (MAR).Results:The expression of GPIba was a little lower, the PARl percentage was higher (P<0.05) and the platelet MAR(%) in the chronic haemodialysis group was obviously lower than in the control subjects (P <0.05). There was a positive relationship between PARl levels and the months of HD(r=0.601,P<0.05).Conclusion:The presence of a high PARl level and more cardiovascular and cerebrovascular events in the HD group may indicate that the increase of platelet PARl level is a risk marker in HD patients. Part two Effects of Salvia Miltiorrhiza Liguspyragine Hydrochlorid and Glucose Injection on the levels of main platelet thrombin receptors in chronic haemodialysis patientsObjective:To investigate the effects of Salvia Miltiorrhiza Liguspyragine Hydrochlorid and Glucose Injection(参芎葡萄糖注射液,SLGI) on the expression of platelet membrane receptors proteinase activated receptor-1(PARl) and proteinase activated receptor-4(PAR4) in end-stage renal disease (ESRD) patients on chronic haemodialysis (HD).Methods:Eighty-six patients in ESRD with HD were treated with SLGI,7days as one therapeutic course, for2successive courses. The previous therapies remained unchanged. Flow cytometry was used to detect the expression of platelet PARl and PAR4in patients, and turbidity method was used to determine the platelet maximum aggregation rate (MAR), meanwhile the renal function was measured. The final data were compared with those before the treatment, and with those in the normal control group (54healthy subjects).Results:Compared with the normal control group, expressions of PARl and PAR4, and platelet MAR in ESRD patients on HD were significantly higher (P=0.001, P=0.006, P=0.008) before the treatment; after the treatment with SLGI, the above indexes in patients were remarkably decreased (P-0.036, P=0.046), except PAR4(P=0.067), but still higher than those in the normal control group, however, it was not statistically significant.Conclusion:(1) The overexpressions of PAR1and PAR4lead to platelet aggregation increased and this might be one of the reasons for the thrombic events in ESRD patients on HD.(2) SLGI was able to down-regulate expressions of PAR1and PAR4in ESRD patients on HD, improve platelet function and regulate platelet activation.