急性胰腺炎患者血小板微粒水平变化及其对中性粒细胞胞外捕获网形成的作用

祁琴琴; 杨彬; 李会会; 鲍峻峻; 李鸿晔; 王兵兵; 梅俏

doi:10.3969/j.issn.1001-5256.2020.04.032

急性胰腺炎患者血小板微粒水平变化及其对中性粒细胞胞外捕获网形成的作用

DOI: 10.3969/j.issn.1001-5256.2020.04.032

安徽医科大学第一附属医院消化内科

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- 出版日期: 2020-04-20

Level of platelet microparticles in acute pancreatitis and their role in the formation of neutrophil extracellular traps

Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University

摘要

摘要: 目的探讨急性胰腺炎（AP）患者血小板微粒（PMPs）水平改变及PMPs促进中性粒细胞胞外捕获网（NETs）形成能力。方法收集2018年9月-2019年8月安徽医科大学第一附属医院55例AP患者血标本,分为轻症急性胰腺炎（MAP）组26例、中度重症急性胰腺炎（MSAP）组17例和重症急性胰腺炎（SAP）组12例,并选取健康体检者15例作为对照组。差速离心分离获得贫血小板血浆,采用流式细胞仪检测PMPs水平。收集对照组中性粒细胞,加入AP患者PMPs共同培养。采用ELISA法检测培养液中髓过氧化物酶（MPO）、中性粒细胞弹性蛋白酶（NE）、组蛋白H3水平,采用激光共聚焦显微镜观察NETs分布情况。计量资料两组间比较采用t检验,多组间比较采用单因素方差分析或Kruskal-Wallis H秩和检验;计数资料组间比较采用χ2检验;相关分析采用Pearson相关性检验。结果与对照组相比[172. 00（148. 25～204. 25）个/μl],MAP、MSAP、SAP组PMPs水平明显升高[179. 50（145. 00～308. 750）个/μl、1117. 50（48...
- 胰腺炎 /
- 血小板微粒 /
- 中性粒细胞胞外捕获网
Abstract: Objective To investigate the change in the level of platelet microparticles( PMPs) in acute pancreatitis( AP) and the ability of PMPs to promote the formation of neutrophil extracellular traps( NETs). Methods Blood samples were collected from 55 patients with AP who were admitted to The First Affiliated Hospital of Anhui Medical University from September 2018 to August 2019,and these patients were divided into mild AP( MAP) group with 26 patients,moderate-severe AP( MSAP) group with 17 patients,and severe AP( SAP) group with 12 patients. A total of 15 healthy individuals who underwent physical examination were enrolled as control group. Platelet-poor plasma( PPP)was separated by differential centrifugation and flow cytometry was used to measure the level of PMPs. Neutrophils were collected from the control group and were co-cultured with the PMPs from AP patients. ELISA was used to measure the levels of myeloperoxidase( MPO),neutrophil elastase( NE),and histone H3 in culture solution,and a laser scanning confocal microscope was used to observe the distribution of NETs. The t-test was used for comparison of continuous data between two groups,and a one-way analysis of variance or the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups; a Pearson correlation analysis was also performed. Results Compared with the control group,the MAP,MSAP,and SAP groups had a significant increase in the level of PMPs [179. 50( 145. 00-308. 750)/μl,1117. 50( 483. 00-2488. 25)/μl,and 1848. 00( 1216. 50-2562. 00)/μl vs 172. 00( 148. 25-204. 25)/μl,H = 4. 348、23. 186、19. 293,all P < 0. 05],and compared with the MAP and MSAP groups,the SAP group had a significant increase in the level of PMPs( H = 29. 068、4. 709,both P < 0. 05). The level of PMPs in AP patients was correlated with APACHEII,BISAP,and Ranson score( r = 0. 636,0. 508,and 0. 430,all P < 0. 001). Compared with the control group,the AP group had significantly increases in the levels of MPO[( 374. 68 ± 92. 01) ng/ml vs( 105. 27 ± 33. 82) ng/ml,t = 9. 105,P < 0. 001],NE[( 267. 45 ± 68. 46) ng/ml vs( 82. 71 ± 19. 22) ng/ml,t = 9. 921,P < 0. 001],and histone H3[( 16. 34 ±4. 02) ng/ml vs( 4. 53 ± 1. 48) ng/ml,t = 7. 524,P < 0. 001],and the formation of NETs was increased under the laser scanning confocal microscope. Conclusion The level of PMPs is significantly increased in AP,which is associated with disease activity. PMPs may promote the formation of NETs and aggravate the progression of AP.
- pancreatitis /
- platelet microparticles /
- neutrophil extracellular traps

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