Early Diagnostic Value Of Platelets Activation In Necrotizing Enterocolitis

Objective:To explore the flow cytometry 3-color analysis of activated platelets and its clinical significance in necrotizing enterocolitis(NEC).This study had monitored variation of the fibrinogen receptor(FIB-R) and P-selectin(CD62P) on the platelet membrane surface used by flow cytometry(FCM) 3-color analysis in necrotizing enterocolitis(NEC),and measured platelet(PLT),mean platelet volume(MPV) of patients,in order to explore the use of FCM's clinical significance and to understand the contribution of platelet functional status in pathogenesis of NEC.The early diagnosis,theraphy,momitoring effect,setimation of prognosis,were dicussed.Methods:The fibrinogen receptor(FIB-R) and P-selectin(CD62P) were used for molecular marker of activated platelets,which were analyzed by flow cytometric3-color immunofluorescence.to analyze patients with high risk of NEC,earlier period patients of NEC,typical patients of NEC and control group.And measured platelet (PLT),mean platelet volume(MPV) of all the groups by blood analyser.Using discriminant analysis,the predictability of outcome was calculated.Results:1.In the quiescent condition,comparing the data with the control group,the positive percentages of PAC-1,CD62P in earlier period patients and typical patients of NEC were significantly higher(p＜0.05,p＜0.01),the positive percentages of PAC-1,CD62P in patients with high risk of NEC didn't have the statistical significance(p＞0.05);comparing the data with the earlier period patients,the positive percentages of CD62P in typical patients of NEC were significantly higher(p＜0.01),the positive percentages of PAC-1 in typical patients of NEC didn't have the statistical significance(p＞0.05);comparing the data with the typical patients of NEC,the positive percentages of PAC-1 and CD62P in their convalescent period were significantly lower(p＜0.05).2.activated by ADP,comparing the data before the activation by ADP,the positive percentages of PAC-1,CD62P were significantly higher in every group(p＜0.05 or p＜0.01),the expression of PAC-1 was related positively to CD62P(r=0.551,p＜0.01);comparing the data with the control group,the positive percentages of CD62P in earlier period patients and typical patients of NEC were significantly higher(p＜0.01),the positive percentages of PAC-1 in typical patients of NEC were significantly higher(p＜0.05),the positive percentages of PAC-1 in earlier period patients didn't have the statistical significance(p＞0.05),the positive percentages of PAC-1,CD62P in patients with high risk of NEC didn't have the statistical significance(p＞0.05);comparing the data with earlier period patients,the positive percentages of CD62P in typical patients of NEC were significantly higher(p＜0.01),the positive percentages of PAC-1 in typical patients of NEC didn't have the statistical significance (p＞0.05);comparing the data with the typical patients of NEC,the positive percentages of PAC-1 and CD62P in their convalescent period were significantly lower(p＜0.05);comparing the data with the control group,the increased extents of the positive percentages of CD62P in earlier period patients and typical patients of NEC were significantly higher(all p＜0.05), the increased extents of the positive percentages of CD62P in patients with high risk of NEC didn't have the statistical significance(p＞0.05); comparing the data with earlier period patients,the increased extents of the positive percentages of CD62P in typical patients of NEC didn't have the statistical significance(p＞0.05).3.Comparing the data with the control group,PLT in earlier period patients and typical patients of NEC were significantly lower(all p＜0.05),PLT in patients with high risk of NEC didn't have the statistical significance (p＞0.05);comparing the data with earlier period patients,PLT in typical patients of NEC were significantly lower(p＜0.05);comparing the data with the control group,MPV in earlier period patients were significantly accrescent(p＜0.05),MPV in patients with high risk of NEC didn't have the statistical significance(p＞0.05);comparing the data with typical patients of NEC,PLT in their convalescent period were significantly higher(p＜0.05).Conclusion:1.Using flow cytometry 3-color immunofluorescence analysis,detecting the FIB-R and CD62P which were used for molecular marker of activated platelets in CAP,can detect the activated index of platelets sensitively and spectially,so offer dependable laboratory data for the clinical evaluation of activation of platelets. 2.Detection of PAC-1 and CD62P by flow cytometry 3-color analysis can offer dependable laboratory data for the early diagnosis,progression of pathogenetic condition,monitoring of f NEC from newborns with high risk of NEC.Especially CD62P is more significant to the progression of NEC;and PLT decreases in NEC patients,increases in their convalescent period,MPV accretes in NEC patients,diminishes in their convalescent period,therefore PLT and MPV can make laboratory index for the early diagnosis,progression of pathogenetic condition,monitoring of curative effect of NEC.3.After activated by ADP,the expression of PAC-1,CD62P of all the groups increase,the expression of PAC-1 is related positively to CD62P,indicates that the both can be used for molecular marker of activated platelets;and the increased extent of CD62P in patients of NEC is more obvious.So the platelet of patients of NEC is more easily activated compared to patients with high risk of NEC and control group.