A Study On The Early Diagnose Value Of The Blood Platelet Membrane Glycoprotein CD62P, CD63 To Progressive Cerebral Infarction

Objective:by measuring the expression rate of the blood platelet membrane glycoprotein CD62P,CD63 and drawing the ROC curve to evaluate the diagnosis value to progressive cerebral infarction.Material and methods:we collected 103 cases,aged from 30 to 80 from the 1^st attiliated hospital of Shanxi Medical University from March 2006 to December 2006,and divided them into two groups:progressive cerebral infarction(n=35),non-progressive cerebral infarction(n=68).The diagnosis is according to the criteria revised by the 4^thCerebrovascular Disease Conference.The head CT and MRI were conducted to make sure that the foci were new. The diagnosis of the progressive cerebral infarction is:the conditions still aggravate through the one-week conventional therapy after 6 hours of the onset and fits one of the following rules:(1) muscle strength droped 1 lever or more on the paralysed side compared with that of the beginning of hospitalization.(2)Neurological function impairment score increased 8 or above; (3)To rule out the possibility of cerebral hemorrhagic by CT after the conditions' worsening. The exclusion criteria were:(1)hemorrhagic cerebrovasular diseases;(2)severe cerebral infarction;(3)patients with serious diseases in heart,lung,kidney,liver and so on;(4)patients who had used anti-coagulation drugs or platelet aggregation inhibitor before the disease onset. The control group included 68 cases who were non-progressive cerebral infarction.We performed detailed physical examination for selected patients and recorded their results of the score according to the criteria passed by the 4th Cerebrovascular Disease Conference.(see the attached listl)We obtained 0.9 ml ulnar vein blood from all the patients,and added it into plastic tube containing 0.1 ml 3.8%critic acid to prevent blood clotting then we marked the sequence number for cytometry tube.In the odder-number tubes we added 20μl mouse anti-person IgG marked by FITC,20μl mouse anti-person IgG marked by PE,20μl anti-CD61 antibody marked by PerCP as negative control tube;in the even- numbered tubes we added 20μl anti-CD61 antibody marked by PerCP,20μl anti-CD62 anti- body marked by PE,20μl anti-CD63 antibody marked by FITC as test tubes;then added 5μl anti-conglulation blood in the flow cytometry tubes respectively,mixed fully,protected from light for 15 minutes;then took it out and added 1%paraformaldehyde solution for fixation, analyzed on the FCM.We examined the patients on the daily bases and recorded the neurological function impairment scores.Result:the difference of expression rates of CD62p and CD63 between the progressive cerebral infarction group and the control group has the statistical significance,P＜0.01.The area under the ROC curve of CD62p expression rate was 0.876,and the area under the ROC curve of CD63 expression rate was 0.893,both of them have statistical significance,P＜0.01.At the inflection point 5.81%of the CD62p expression rate,the sensitivity was 83%,the specificity was 84%,the positive predictive value was 73%,and the negative predictive value was 86%, the accuracy(correct rate)was 84%.At the inflection point 2.925%of the CD63 expression rate, the sensitivity was 83%,the specificity was 82%,the positive predictive value was 71%and the negative predictive value was 90%,the accuracy(correct rate)was 83%.Conclusion:1.The progressive cerebral infarction group has higher CD62p and CD63 expression rate than the non-progressive cerebral infarction,which demonstrates that the platelet's activity of the progressive cerebral infarction patients is in a higher degree.2.The areas under the ROC curve of CD62p and CD63 expression rate are 0.876 and 0.839 respectively;the inflection point of the CD62p and CD63 expression rate are 5.81%and 2.925%respectively,the accuracy of the diagnosis are 84%and 83%respectively. Therefore,we can anticipate the occurrence of the progressive cerebral infarction in a better way by measuring the expression rate of CD62p and CD633.The paralled diagnosis method of CD62p and CD63 expression rate can increase the sensitivity greatly,reduce the missed diagnosis rate,and enable the patients to be diagnosed and treated in time.