冠心病患者血小板活化状态研究

目的了解冠心病不同阶段血小板活化状态的变化.方法选择47例经冠状动脉造影证实为冠心痛的20例急性心肌梗死及30例正常人为研究对象,并将冠心病患者分为多支病变组及单支病变组,测定各对象的血浆α-颗粒膜蛋白(GMP-140)浓度,及经ADP活化后血浆GMP-140浓度.结果急性心肌梗死组、不稳定型心绞痛组分别与稳定型心绞痛组及正常组相比,血浆GMp-140显著升高(P＜0.01),稳定型心绞痛组与正常组相比差异无显著性;用ADP活化后,各组血浆GMP-140均较活化前升高(P＜0.01),且活化后急性心肌梗死组、不稳定型心绞痛组及稳定型心绞痛组血浆GMP-140均高于正常组(P＜0.01,P＜0.01,P＜0.05);在冠状动脉单支与多支病变组间,血浆GMP-140无差异.结论冠心病患者不同阶段血小板活化状态不同,急性冠状动脉综合征患者血小板活化程度高,血小板活化程度与冠状动脉病变支数无显著相关.

Investigation of changes of platelet activating state in coronary heart disease

Objective: To investigate the changes of platelet activating state in different stage in coronary heart disease. Methods: 47 patients with angiographically documented coronary heart disease (25 with unstable angina, 22 with stable angina), 20 patients with acute myocardial infarction and 30 healthy individuals were selected as subjects. We examined their plasma concentration of alphagranule membrance protein (GMP-140), GMP-140 after ADP stimulated. Results: Patients with acute myocardial infarction or unstable angina had significantly higher plasma GMP-140 than those with stable angina and healthy individuals (P<0.01). GMP-140 was significantly increased in every group after ADP stimulated (P<0.01). Plasma GMP-140 in patients with AMI, unstable angina or stable angina was significantly higher than the healthy individuals after ADP stimulated (P<0.01, P<0.01, P<0.05). There were no significant differences in plasmas GMP-140 between multivessel disease and single vessel disease. Conclusions: Platelet activity is different in different stage of coronary heart disease. Platelet activity increases in patients with acute coronary heart disease. Platelet activity increases in patients with acute coronary artery syndrome. There is no GMP-140 difference between multivessel and single vessel disease.