抑郁症对STEMI患者经皮冠状动脉介入治疗(PCI)前后血小板活化影响研究

The Clinical Study the Inflwence of Depression on Platelet Activation in STEMI Patients Treated with Primary PCI

目的:探讨抑郁症对急性ST段抬高型心肌梗死(STEM I)经皮冠状动脉介入治疗(PCI)前后血小板活化影响。方法:209例行PCI的患者分为抑郁症组(72例,包括持续性抑郁患者31例和一过性抑郁患者41例)和非抑郁症组(137例)。对照组35例为冠状动脉造影正常患者。分别于术前1天内和术后3个月通过BECK抑郁自评问卷(BD I)进行心理测评。取外周血,以β-血小板球蛋白(β-TG)作为血小板活化标志物,ELISA法测定浓度。结果:PCI组术前β-血小板球蛋白(β-TG)浓度水平较对照组明显升高,术后下降,持续抑郁症组β-TG浓度较非抑郁症组升高。对照组β-血小板球蛋白(β-TG)浓度在冠状动脉造影前后无显著性变化。结论:血小板活性在PCI前后有动态改变,在合并持续抑郁症患者中,血小板的活化程度较高。

Objective： To evaluate the inflwence of depression on the state of PLT activation in patients with STEMI treated with primary PCI. The assessment of PLT activation was based on the concentration of β - TG as serum markers of the activation. Method： The study group consisted of 209 patients with STEMI treated with primary PCI which was divided into two groups： Group A - 137 persistently nondepressed patients,and group B- 72 patients with depression,including 31 persistently depressed patients and 41 remittent depressed patients. The control group consisted of 35 healthy subjects an immunoenzymatic method （ ELISA, stago diagnostic ） was used to measure the β - thromboglobulin blood plasma concentration. β - TG was measured at baseline and 3 months after PCI. Result： Post -procedural levels of β -TG showed a decrease compared with preprocedural levels . Preprocedural peak levels of β - TG were higher in patients with depression than those in patients without depression. Conclusion： Intravascular platelet activation showed a dynamic change before and after PCI. Patients with STEMI suffering from depression show enhanced intravascular platelet activation.