CAJ | 학술논문

目的观察冠心病患者冠状动脉支架植入术前后不同时段血小板活化标志物的变化并探讨其临床意义.方法利用流式细胞术(FCM)检测冠心病患者冠状动脉支架植入术前、术后即刻及术后2、4、6和24h,外周血中可溶性P-选择素(CD62P)和血小板活化糖蛋白GPⅡb/Ⅲa纤维蛋白原受体(PAC-1)的含量.结果 65例患者术后即刻CD62P[40.63 (25.14 ～ 51.01)％]和PAC-1[36.59(20.37～48.41)％]含量显著高于术前水平[14.79(9.85～26.66)％,13.99(11.42 ～30.13)％](P＜0.05);CD62P和PAC-1术后2 h[8.64(4.48 ～15.67)％,12.64(6.45 ～ 18.83)％]、4 h [7.91 (4.56～12.94)％,12.81 (6.89 ～ 18.66)％]、6 h[6.53(4.12～9.27)％,9.43(5.27～15.65)％]、24H[6.28 (4.36 ～9.63)％,10.38(4.63 ～18.11)％]结果显著下降,均低于术前水平(P＜0.05).结论支架植入术后2h内对冠状动脉内皮的损伤加强了血小板的活化,增加了血栓形成的风险.
목적 관찰관심병환자관상동맥지가식입술전후불동시단혈소판활화표지물적변화병탐토기림상의의.방법 이용류식세포술(FCM)검측관심병환자관상동맥지가식입술전、술후즉각급술후2、4、6화24h,외주혈중가용성P-선택소(CD62P)화혈소판활화당단백GPⅡb/Ⅲa섬유단백원수체(PAC-1)적함량.결과 65례환자술후즉각CD62P[40.63 (25.14 ～ 51.01)％]화PAC-1[36.59(20.37～48.41)％]함량현저고우술전수평[14.79(9.85～26.66)％,13.99(11.42 ～30.13)％](P＜0.05);CD62P화PAC-1술후2 h[8.64(4.48 ～15.67)％,12.64(6.45 ～ 18.83)％]、4 h [7.91 (4.56～12.94)％,12.81 (6.89 ～ 18.66)％]、6 h[6.53(4.12～9.27)％,9.43(5.27～15.65)％]、24H[6.28 (4.36 ～9.63)％,10.38(4.63 ～18.11)％]결과현저하강,균저우술전수평(P＜0.05).결론 지가식입술후2h내대관상동맥내피적손상가강료혈소판적활화,증가료혈전형성적풍험.
Objective To explore the platelet activation status before and after coronary artery stent implantation at different timepoints.Methods The contents of CD62P (soluble P-selectin) and PAC-1 (platelet glycoprotein GP Ⅱ b/ Ⅲ a fibrinogen receptor) in patients after coronary stent implantation were detected by flow cytometry (FCM) before,immediately after surgery,postoperative 2,4,6 and 24 h in peripheral blood.Results In 65 cases,the levels of CD62P [40.63 (25.14-51.01) ％] and PAC-1 [36.59(20.37-48.41)％] immediately after surgery were significantly higher than their preoperative values [14.79(9.85-26.66)％,13.99(11.42-30.133)％] (P ＜0.05).And the postoperative levels of 2 h [8.64(4.48-15.67)％,12.64(6.45-18.83)％],4 h [7.91 (4.56-12.94)％,12.81 (6.89-18.66)％],6h [6.53(4.12-9.27)％,9.43(5.27-15.65)％] and 24 h [6.28(4.36-9.63)％,10.38 (4.63-18.11) ％] decreased significantly versus their preoperative values (P ＜ 0.05).Conclusion Stenting of coronary endothelial damage within 2h may enhance platelet activation and boost the risk of thrombosis.