血小板微粒在肺血栓栓塞症中的作用

许兰 ，傅应云

（1 .暨南大学第二临床学院，广东 深圳，518000 ；2 .深圳市人民医院呼吸与危重症医学科，广东 深圳，518000）

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摘要：

血小板微粒（PMPs）是血小板或巨核细胞在活化或凋亡过程中释放出来的直径小于1 μm的微小囊泡，它与促凝作用、 内皮功能紊乱、炎症反应等血栓形成、进展、转归的病理过程密切相关，有可能成为肺血栓栓塞症的新的生物标志物、治疗靶点及监测抗凝疗效的新指标。本文对PMPs的形成过程、生物学特性、在肺血栓栓塞症中的作用进行了论述。

关键词：血小板微粒；血栓形成；肺血栓栓塞症

中图分类号：R563.5文献标志码：A文章编号：2096-1413(2017)11-0187-03

The role of platelet microparticles in pulmonary thromboembolism
XU Lan 1,2, FU Ying-yun 1,2
(1. the 2nd Clinical Medical College of Jinan University, Shenzhen 518020; 2. Department of Respiratory
and Critical Care, Shenzhen People's Hospital, Shenzhen 518000, China)

ABSTACT：Platelet-derived microparticles (PMPs) are small extracellular vesicles (less than 1 μm in diameter) whichshed from megakaryocytes and platelets upon their activation or apoptosis. PMPs are involved in a variety of pathophysiological responses including procoagulation, endothelial dysfunction, inflammation. They are likely to play key roles in the occurence and development of thrombus, and may serve as biomarkers for pulmonary thromboembolism status or as a possible new target for anti-platelet drugs, as well as a new indicator for antithrombotic activity. This paper discusses PMPs formation, biological characteristics and the role in pulmonary thromboembolism.
KEYWORDS：platelet-derived microparticles; thrombosis; pulmonary thromboembolism

参考文献：
[1] BOILARD E,DUCHEZ AC,BRISSON A.The diversity of platelet miroparticles[J].Curr Opin Hematol,2015,22(5):437-444.
[2] MEZOUAR S,MEGE D,DARBOUSSET R,et al.Involvement of platelet-derived microparticles in tumor progression and thrombosis[J]. Semin Oncol,2014,41(3):346-358.
[3] HARGETT LA,BAUER NN.On the origin of microparticles: From "platelet dust" to mediators of intercellular communication[J].Pulm Circ, 2013,3(2):329-340.
[4] CAUWENBERGHS S,FEIJGE MA,HARPER AG,et al.Shedding of procoagulant microparticles from unstimulated platelets by integrin-mediated destabilization of actin cytoskeleton[J].FEBS Lett,2006,580(22): 5313-5320.
[5] NOMURA S,SHIMIZU M.Clinical significance of procoagulant microparticles[J].J Intensive Care,2015,3(1):2.
[6] VAN DER MEIJDEN PE,VAN SCHILFGAARDE M,VAN OERLE R,et al.Platelet-and erythrocyte-derived microparticles trigger thrombin generation via factor XIIa[J].J Thromb Haemost,2012,10(7):1355-1362.
[7] SUADES R,PADRO T,VILAHUR G,et al.Circulating and platelet -derived microparticles in human blood enhance thrombosis on atherosclerotic plaques[J].Thromb Haemost,2012,108(6):1208-1219.
[8] PRESTON RA,JY W,JIMENEZ JJ,et al.Effects of severe hypertension on endothelial and platelet microparticles [J].Hypertension,2003,41 (2):211-217.
[9] XIE RF,HU P,WANG ZC,et al.Platelet -derived microparticles in -duce polymorphonuclear leukocyte -mediated damage of human pulmonary microvascular endothelial cells[J].Transfusion,2015,55(5):1051-1057.
[10] BOILARD E,NIGROVIC PA,LARABEE K,et al.Platelets amplify inflammation in arthritis via collagen -dependent microparticle production[J].Science,2010,327(5965):580-583.
[11] DUARTE D,TAVEIRA-GOMES T,SOKHATSKA O,et al.Increased circulating platelet microparticles as a potential biomarkner in asthma [J].Allergy,2013,68(8):1073-1075.
[12] BELOHLAVEK J,DYTRYCH V,LINHART A.Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism [J].Exp Clin Cardiol,2013,18(2):129-138.
[13] CAMPELLO E,SPIEZIA L,RADU CM,et al.Circulating microparticles and the risk of thrombosis in inherited deficiencies of antithrombin, protein C and protein S[J].Thromb Haemost,2016,115(1):81-88.
[14] INAMI N,NOMURA S,KIKUCHI H,et al.P-selectin and platelet -derived microparticles associated with monocyte activation markers in patients with pulmonary embolism[J].Clin Appl Thromb Hemost,2003,9 (4):309-316.
[15] BAL L,EDERHY S,DI ANGELANTONIO E,et al.Factors influencing the level of circulating procoagulant microparticles in acute pulmonary embolism[J].Arch Cardiovasc Dis,2010,103(6-7):394-403.
[16] 马军,吴一龙,秦叔逵,等.中国肿瘤相关静脉血栓栓塞症预防与治疗专家指南(2015版)[J].中国实用内科杂志,2015,35(11):907-919.
[17] CAMPELLO E,SPIEZIA L,RADU CM,et al.Endothelial, platelet, and tissue factor -bearing microparticles in cancer patients with and without venous thromboembolism[J].Thromb Res,2011,127(5):473-477.
[18] HU Q,WANG M,CHO MS,et al.Lipid profile of platelets and platelet-derived microparticles in ovarian cancer[J].BBA Clin,2016(6): 76-81.