经皮冠状动脉腔内支架植入术后血小板L-精氨酸/一氧化氮途径的变化

Change of the L-Arginine/Nitric Oxide Pathway of Platelet after Coronary Artery Stent Implantation

通过观察冠心病人PTCA支架植入术后血小板一氧化氮（NO）生成、NO合酶（NOS）活性和L-精氨酸（L－Arg）转运的变化，探讨PTCA支架术后血小板功能受损的机制。方法：正常对照组14例，其中男8例，女6例，平均年龄52．6±5．5岁；冠心病组11例，其中男9例，女2例，平均年龄53．3±4．8岁。对照组、冠心病组术前及术后不同时期分别取血测定血小板NO生成、NOS活性及L－Arg转运。结果显示：冠心病患者术前血小板NO生成、NOS活性及L－Arg转运明显低于正常对照组，且于术后即刻进一步下降（P＜0．01）；之后有所恢复，但至术后第6天仍未恢复正常（P＜0．05）。意义：PTCA支架术可能通过降低血小板NO合酶活性和L－Arg转运使血小板NO生成减少，此可能是术后血小板粘附聚集的原因之一。

To study the mechanism of the dysfunction of platelet after coronary artery stent implantation (CASI),we observed the change of the product of nitric oxide (NO),activity of NO synthase (NOS) and L-Arginine transport before and after CASI. The study included two groups:Ga (14 normal co-ntrols) and Gb (11 patients with coronary artery disease). The result showed that the product of NO,NOS activity and L-Arg transport of platelet in Gb were lower than in Ga (P<0.01),and further decreased aft-er stent implantation compared with the level before the procedure (P<0.01). After that,the NO product,the activity of NOS and L-Arg transport recovered gradually,but still remained abnormal on the sixth day after the procedure (P<0.05).We inferred that CASI maybe decreased the NO product of platelet by i-nfluencing the NOS activity and L-Arg transport. This may be one of the mechanisms of adhesion and aggregation of platelet after coronary artery stent implantation.