血小板活化功能检测在急性心肌梗死及不稳定性心绞痛时的临床初步应用

Preliminary Application of Platelet Activation to Acute Myocardial Infarction and Unstable Angina Pectoris

目的：观察急性心肌梗死和不稳定性心绞痛患者血小板的活化状态并探讨其临床意义。方法：分别采用抗人活化型血小板α－颗粒膜蛋白－１４０（ＧＭＰ－１４０）及血小板膜糖蛋白Ⅱｂ／Ⅲａ（ＧＰⅡｂ／Ⅲａ）的特异性单克隆抗体，以放射免疫法测定１７例急性心肌梗死和１５例不稳定性心绞痛患者血小板的活化状态，并将其与心肌酶、心肌梗死和缺血面积作相关分析。结果：急性心肌梗死组和不稳定性心绞痛组血小板ＧＭＰ－１４０数目明显高于正常对照组（Ｐ＜０．０１）。ＧＭＰ－１４０与血清肌酸激酶及其ＭＢ同工酶、血清乳酸脱氢酶（ＬＤＨ）、心肌梗死和缺血面积均呈正相关（Ｐ＜０．０５）。急性心肌梗死组和不稳定性心绞痛组血小板膜ＧＰⅡｂ／Ⅲａ分子数均明显高于正常对照组（Ｐ＜０．０５），但两组分子数与心肌梗死和缺血面积均不具有相关性。

Objective:To study the platelet activation in patients with acute myocardial infarction and unstable angina pectoris and its clinical significance. Methods:The monoclonal antibodies specific for α granule membrane protein 140(GMP 140)and platelets glycoprotein Ⅱb/Ⅲa complex(GPⅡb/Ⅲa)were used respectively to evaluate the platelet activation in 17 cases with acute myocardial infarction and 15 cases with unstable angina pectoris by radioimmunoassay.Moreover,the correlation analysis was made between GMP 140、myocardial enzymes and ischemic/infarct size. Results:The number of GMP 140 molecules on platelet surface of patients who were at the acute stage of acute myocardial infarction and unstable angina pectoris were significantly increased as versus normal controls( p <0 01).The data showed good correlations between GMP 140 and CK,MB CK,LDH or ischemic or infarct size (all p <0 05);the number of GP Ⅱb/Ⅲa complex molecules on platelet membrane surface of acute myocardial infarction or unstable angina pectoris were significantly higher than normal subjects( p <0 05),but they had no correlation to the ischemic/infarct size. Conclusion:The detection of platelet activation has certain applicability in acute myocardial ischemia.