急诊PTCA及支架术前后血清GMP-140的变化及临床意义

Changes of serum granule membrane protein before and after PTCA and in-stent inplantation

目的 :通过测定急性心肌梗死 (AMI)病人在急诊经皮冠状动脉腔内成形术 (PTCA)及支架术前后血浆α -颗粒膜蛋白 (GMP -14 0 )的含量 ,探讨急性心肌梗死病人在急诊PTCA及支架术后血小板的活化状态及内皮损伤情况。方法 :选取在发病 12h内行PTCA及支架置入术治疗的急性心肌梗死病人 15例 ,分别在术前、术后即刻、术后 1h及术后 2 4h采静脉血 ,用酶联免疫法 (ELISA)测GMP -14 0的含量。结果 :PTCA及支架术前GMP -14 0的含量明显高于正常对照组 (P <0 .0 1)。GMP -14 0在术后即刻和术前相比明显增高 (P <0 .0 1) ,术后 1h和术前相比下降 (P <0 .0 1) ,术后 2 4h较术前及术后 1h明显降低 (P <0 .0 1) ,但仍高于正常对照组 (P <0 .0 1)。结论 :急性心肌梗死病人在PTCA及支架术前存在内皮损伤和血小板的活化 ,在PTCA及支架术后血小板的活化呈现下降趋势 ,损伤的内皮逐渐修复 。

Objective:To assess the effect of the plasma level of alpha-granule membrane protein(GMP-140) before and after percutaneous transluminal coronary angioplasty(PTCA) and in-stent implantation on patients with acute myocardial infarction(AMI).Methods:15 patients with AMI who underwent immediate PTCA and in-stent implantation within 12 hours. Blood samples were obtained from wein before and immediately after PTCA and at the first hour, the 24 th hour after the procedure respectively: GMP-140 was measured by Enzyme Linked Immunosorbent Assay(ELISA).Results:the plasm level of GMP-140(ngml) in AMI patients were highter than that of 20 healthy volunteers before PTCA and in-stent(P<0.01). They increased immediately after PTCA and in-stent(P<0.01) and decreased at the first hour after the procedure(P<0.01). The level of them decreased significantly at the 24 th hour after the procedure(P<0.01), but they were higher than that of 20 healthy volunteers (P<0.01).Conclusion:There were endothelial lesion and platelet activation in AMI patients before PTCA and in-stent. The platelet activation show descending tendency after PTCA and in-stent implatation, the ability of rethrombosis dropped.