急性心肌梗塞溶栓治疗中血小板活化状态的动态改变

Alteration of platelet activation status in the patients with acute myocardial infarction during thrombolytic therapy

血小板表面CMP－140是反映血小板活化的特异性指标。应用活化依赖性单克隆抗体测定27例急性心肌梗塞（AMI）患者联合溶栓、常规治疗中血小板表面GMP－140、血浆内GMP-140，以及血浆血栓素B2、6-酮-前列腺素F1α的改变。观察到以上指标在AMI早期增高，说明血小板处于高活化状态。在AMI不同治疗中以上指标呈不同的动态变化。溶栓再通患者的血小板表面GMP－140比未再通的患者较早恢复正常。结果提示血小板表面GMP－140与血栓形成及溶解有关，是判定溶栓效果的一项重要指标。在AMI患者溶栓同时联合应用特异性高、效力强的抗血小板药物将对溶栓治疗产生促进作用。

α-granule membrane protein (GMP-140) of platelet surface and plasma, plasma thromboxane B2 and 6-keto-prostaglandin were determined in 27 patients with AMI. The patients were divided into routine treatment group (n=13) and combination thrombolytic group (n = 14,urokinase, heparin, aspirin). The above indexes were markedly elevated in the patients with AMI. lt showed that platelets were in high activation status. In different treatment group, above indexes showed different alteration. Eight cases of thrombolytic group showed evidence of reperfusion in whom GMP-140 of platelet surface was restored to normal level early than that in others of thrombolytic group. The resutls suggest GMP-140 of platelet surface inay be an important index to assessed thrombolytic effect. In early stage of AMI, platelets are in a higher activation status.Thrombolytic agents in combination with potent specific antiplatelet agent will produce a promoted action for thrombolytic therapy.