急性冠脉综合征患者血小板活化状态的临床研究

Platelet activation in patients with acute coronary syndrome

目的探讨急性冠脉综合征(ACS)患者的血小板活化状态及其意义。方法根据冠脉造影将66例可疑急性冠脉综合征患者分为ACS组(45例)和对照组(非冠心病组21例),用流式细胞仪检测CD62P和CD63。并根据性别、冠脉病变严重程度和血LDL-C水平对ACS患者分组,分别比较各组间CD62P和CD63的表达。结果ACS组CD62P(5.12±3.95)%、CD63(5.20±3.54)%,分别高于对照组CD62P(2.64±1.31)%、CD63(2.57±1.67)%(均P<0.01);两指标测定ACS的敏感性为73.33%和71.11%,而特异性为71.43%和76.19%,其界值点分别为2.59%和3.05%。在ACS患者中,性别对血小板的CD62P和CD63影响不显著(P>0.05);三支组和双支组的CD62P和CD63的表达均高于单支组(P<0.05);三支组与双支组间的CD62P、CD63差异无显著性意义(P>0.05);高LDL-C组的CD62P、CD63高于低LDL-C组(P<0.01)。结论ACS患者存在高度的血小板活化,性别对ACS患者血小板活化无显著影响,血小板活化程度随冠脉病变加重和高LDL-C水平而增加。

Objective To explore the platelet activation state in patients with acute coronary syndrom（ACS） and its significance . Methods CD62P and CD63 were detected by flow cytometry （FCM） in 45 patients with ACS and 21 controls. All 66 patients underwent elective coronary arteriography. There were 13 patients with single-vessel disease , 11 with double-vessel disease and 22 with three-vessel disease. There were 31 patients with high LDL-C and 14 with low LDL-C. Results CD62P and CD63 in ACS group were significantly higher than those in controls （5.12% ± 3.95% vs 2.64% ± 1.31% ,5.20%±354% vs 2.57% ± 1.67%. P 〈 0.01）. For ACS,the sensitivity of CD62P and CD63 was 73.33% and 71.11% respectively. The peculiarity was 71.43% and 76, 19% , respectively. The two parameters were no significant difference between male and female（ P 〉 0.05 ）. CD62P and CD63 expression of double and three-vessel disease groups had significantly increased than those of single-vessel disease group（ P 〈0.05 and P 〈0.01 }. The two parameters of high LDL-C group were lower than LDL-C group （ P 〈 0.01 ）. Conclusion There is elevated platelet activation in patients with ACS. The platelet acjivation is no significant difference between male and female. Platelet activation raises with the increase of severity of coronary artery disease and high level of LDL-C.