The Differences Of Platelet PAC-1,CD62p Positive Rates And Serum PF4 Levels In Large Artery Atherosclerosis And Small Vessel Disease

Objective:To compare the differences of platelet membrane glycoproteins PAC-1,CD62p positive rates in patients with large artery atherosclerosis (LAA) and small vessel disease (SVD) and its subtypes,and compare with the traditional platelet activation and inflammation marker platelet factor 4 (PF4)Methods:The total of 30 patients with large artery atherosclerosis and 45 SVD and 30 controls from General Hospital of Tianjin Medical University were included in the study. SVD were divided into three subgroups according to the imaging findings.All the patients according to classification of TOAST and the diagnostic criteria of imaging of Leukoaraiosis:(1) Large artery atherosclerosis:infarct greater than 15mm in diameter on CT or MRI,with evidence of a stenosis involving intracranial or extracranial large arteries that supply the area of infarction,detected by TCD, MRA, CTA, or DSA,etc.No evidence of potential cardiac-origin embolic cause,and other possible causes have also been excluded. (2) Lacunar infarction:infarct less than 15mm in diameter on CT or MRI,no evidence of atherosclerosis detected by TCD, MRA, CTA, or DSA,etc. No evidence of potential cardiac-origin embolic cause,and other possible causes have also been excluded.(3) Leukoaraiosis:bilateral and either diffuse areas of hypodensity on CT or hyperintensity on MRI-T2 of white matter,also no evidence of atherosclerosis detected by TCD, MRA, CTA, or DSA,etc.Gather the information about all people's age,male,use of alcohol or cigarette,history of hypertension,etc.The positive persents of PAC-1 and CD62p in all objects were measured with flow cytometry.Serum PF4 levels was assessed by ELISA.All the datas were analysed by SPSS 17.0 software.Results:1.The basic clinical information between large artery atherosclerosis,small vessel disease and controls and different subtypes of SVD appear no difference (P>0.05).2.The positive persents of PAC-1,CD62p and the levels of PF4 are significantly higher in the large artery atherosclerosis[(63.21±9.78)%,(55.91±8.17) % and (30.55±15.56)ng/ml] than the small vessel disease[(40.65±17.42)%. (36.49±14.60)% and (12.59±5.57)ng/ml] (P<0.05),and the later higher than the controls [(13.55±3.14)%,(9.00±2.32)% and (4.95±2.82) ng/ml] (P<0.05).3. During each hypotype of SVD,the positive persents of PAC-1,CD62p and the levels of PF4 in Leukoaraiosis-Lacunar infarction[(47.72±15.52)%,(43.75±12.54)% and (13.96±5.23) ng/ml] and simple Lacunar infarction [(49.87±14.65)%,(43.98±10.55)% and (14.41±5.53)ng/ml]are significantly higher than in simple Leukoaraiosis[(24.44±8.45)%,(21.74±7.19)% and (9.40±4.99)ng/ml](P<0.05),but there is no difference between the first two (P>0.05).4. The expression of PAC-1 correlated with CD62p(r=0.964,P=0.000). The levels of PF4 were respectively with PAC-1(r=0.846,P=0.000)and CD62p(r=0.857,P=0.000) linear correlation.Conclusions:PAC-1,CD62p expression are linearly related, participating and promoting thrombosis,and with PF4 concentration shows correlation.Platelet activation and mediated inflammatory mechanisms in the process of atherosclerosis and thrombosis play an important pathophysiological role.This mechanism is still heterogeneity between each types, it has great theory value for guiding clinical therapy,this may need different treatment.