CAJ | 학술논문

目的：通过观察急性冠脉综合征患者血小板平均体积的变化，探讨其在冠脉病变严重程度、粥样硬化斑块稳定性判定中的意义。方法将92例入选研究对象依据临床表现及冠脉造影结果分为：急性冠脉综合征组（ ACS组）51例，稳定型心绞痛组（ SAP组）16例，正常对照组25例。依据临床类型将ACS组分为不稳定型心绞痛组（ UAP组）31例和急性心肌梗死组（ ANI组）20例，依据冠脉病变支数将ACS组分为单支病变组12例、双支病变组15例、三支病变组24例。所有患者入院时检测血小板平均体积（ NPV）及血生化指标。结果与SAP组和正常对照组相比，ACS组NPV升高，差异均有统计学意义（ P＜0.05）；与正常对照组比，SAP组 NPV升高，差异有统计学意义（P＜0.05）。与UAP亚组相比，ANI亚组NPV升高，差异有统计学意义（P＜0.05）。ACS组中不同冠脉病变支数亚组之间NPV水平无统计学差异（ P＞0.05）。ACS组 NPV水平与冠脉 Gensini 积分呈低度正相关（ r ＝0.331，P ＜0.05）。结论 NPV的水平与Gensini积分呈低度正相关，其可在一定程度上反映冠脉病变程度。ACS患者NPV显著升高，NPV水平可以反映冠脉粥样硬化斑块的稳定性，提示 NPV在急性冠脉综合征危险度评估中具有一定的价值。
목적：통과관찰급성관맥종합정환자혈소판평균체적적변화，탐토기재관맥병변엄중정도、죽양경화반괴은정성판정중적의의。방법장92례입선연구대상의거림상표현급관맥조영결과분위：급성관맥종합정조（ ACS조）51례，은정형심교통조（ SAP조）16례，정상대조조25례。의거림상류형장ACS조분위불은정형심교통조（ UAP조）31례화급성심기경사조（ ANI조）20례，의거관맥병변지수장ACS조분위단지병변조12례、쌍지병변조15례、삼지병변조24례。소유환자입원시검측혈소판평균체적（ NPV）급혈생화지표。결과여SAP조화정상대조조상비，ACS조NPV승고，차이균유통계학의의（ P＜0.05）；여정상대조조비，SAP조 NPV승고，차이유통계학의의（P＜0.05）。여UAP아조상비，ANI아조NPV승고，차이유통계학의의（P＜0.05）。ACS조중불동관맥병변지수아조지간NPV수평무통계학차이（ P＞0.05）。ACS조 NPV수평여관맥 Gensini 적분정저도정상관（ r ＝0.331，P ＜0.05）。결론 NPV적수평여Gensini적분정저도정상관，기가재일정정도상반영관맥병변정도。ACS환자NPV현저승고，NPV수평가이반영관맥죽양경화반괴적은정성，제시 NPV재급성관맥종합정위험도평고중구유일정적개치。
Objective To observe the change of mean platelet volume in patients with acute coronary syndrome,and explore the determination significance of which in severity of coronary artery disease and atherosclerotic plaque stability. Meth-ods 92 cases of patients were selected into this experiment and divided into acute coronary syndrome(ACS)group(51 ca-ses),stable angina group(SAP 16 cases),normal control group(25 cases)based on clinical manifestations and results of CAG. Then the ACS group was divided into unstable angina( UAP group)and acute myocardial infarction( ANI group)based on clinical types,which was divided into single-vessel disease,double-vessel disease,three-vessel disease according to the num-ber of diseased coronary branches. All patients were tested mean platelet volume( NPV)and blood biochemistry on admission. Results Compare with SAP group and the normal control group,the NPV of ACS group increased,the differences were statis-tically significant( P<0. 05);Compared with normal control group,SAP group's NPV increased,the difference was statistical-ly significant(P<0. 05). Compared with UAP subgroup,ANI subgroup's NPV increased,the difference was statistically sig-nificant(P<0. 05). ACS group in different subgroups of coronary artery lesion count was no significant difference between the NPV levels(all P> 0. 05). ACS group's NPV levels and coronary Gensini scores have low positive correlation(r=0. 331, P<0. 05). Conclusion NPV levels has low positive correlation with coronary lesion count Gensini score,which may reflect the extent of coronary artery disease to some extent. NPV has significantly higher in ACS group,and the NPV levels can reflect coronary atherosclerotic plaque stability,which suggests that NPV has a certain value in risk assessment of acute coronary syn-drome .