慢性期脳梗塞患者における活性化血小板検出 : 散乱光法による自然凝集とフローサイトメトリー法の比較検討  [in Japanese] Detection of Activated Platelets in Patients with Chronic Cerebral Infarction (CCI) : Relationship between Spontaneous Platelet Aggregation (SPA) and Activated Platelets determined by Flow Cytometry  [in Japanese]

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Abstract

目的 : 本研究においてわれわれは, 活性化血小板検出のためのレーザー散乱光法と活性化血小板マーカーを用いたフローサイトメトリー法の感度・特異度を検討した. 方 法 : 対象は, 慢性期脳梗塞患者35例. 対照として年齢のマッチした16例を用いた. 自然凝集能とくに小凝集塊 (レーザー散乱光法), そして血小板活性化特異的モノクローナル抗体 (抗CD62P抗体とPAC-1) とフローサイトメトリーによる測定を行い, 感度, 特異度, 各検査間の相関を比較した. 結 果 : 自然凝集能, CD62P陽性率, PAC-1陽性率の感度はカットオフ値を対照群における平均値+2SDに設定するとおのおの37.1%, 60%, 60%, 特異度は100%, 100%, 94%であった. また, ROC曲線 (判断分析) による評価では, 抗CD62P抗体とPAC-1のAUC (ROC曲線より下の面積) が, おのおの0.866±0.049, 0.847±0.055に比し, 自然凝集能 (Smax) は0.752±0.068と低値を示したが, 自然凝集能とCD62P陽性率, PAC-1陽性率に統計的有意差は得られなかった. 散乱光法による自然凝集とCD62P, PAC-1陽性率の間に有意の相関がみられた. 結 論 : フローサイトメトリーによる検出法は, レーザー散乱光に比し感度に優れ, 血小板活性化の検出法として有用である.

We compared the sensitivity and specificity of two methods to detect platelet activation, i.e., the spontaneous platelet aggregation of small aggregates (SPA) and the flow cytometric method, and determined the correlation between these two methods. Thirty-five patients with chronic cerebral infarction (CCI) and 19 age-matched control subjects were enrolled in this study. Platelet activation was first determined by SPA using laser light scattering. Platelet activation was also measured by flow cytometry and two activation-dependent monoclonal antibodies (MoAbs), a MoAb against CD62P (MoAb-CD62P) and a MoAb against the platelet fibrinogen receptor (PAC-1). When cut off points were set at the mean+2SD (standard deviation) of the control subjects, the SPA, MoAb-CD62P and PAC-1 methods demonstrated sensitivity of 37.1%, 60% and 60%, and specificity of 100%, 100% and 94%, respectively. When ROC (Receiver Operating Characteristics) curves were drawn based on these methods, however, the differences in AUC were not statistically significant. There was a statistically significant correlation between the SPA value and the CD62P positive rate, and also between the SPA value and the PAC-1 positive rate. The PAC-1 and the MoAb-CD62P methods were more sensitive than the SPA method in detecting platelet activation in CCI patients.

Journal

  • Japanese Journal of Thrombosis and Hemostasis

    Japanese Journal of Thrombosis and Hemostasis 12(4), 294-299, 2001-08-01

    The Japanese Society on Thrombosis and Hemostasis

References:  18

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008636204
  • NII NACSIS-CAT ID (NCID)
    AN10353762
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09157441
  • Data Source
    CJP  CJPref  J-STAGE 
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