尿激酶及阿司匹林对血浆α-颗粒膜蛋白140的影响及意义

Effect of Urokinase and Aspirin on the Concentration of Plasma GMP 140

目的：探讨急性心肌梗塞（ＡＭＩ）患者尿激酶静脉溶栓及阿司匹林口服治疗前后血小板活性的动态变化及与血管再通的关系。方法：８０例ＡＭＩ患者，随机分成溶栓组及溶栓＋阿司匹林组各４０例，于溶栓前及溶栓后２、６、１２、２４小时测定血浆中α－颗粒膜蛋白１４０（ＧＭＰ－１４０）浓度，依临床间接指标（３８例行冠状动脉造影）判定血管再通，比较两组间及两组中再通与未通患者血浆ＧＭＰ－１４０浓度的动态变化。正常对照组６０例。结果：ＡＭＩ患者溶栓前后血浆ＧＭＰ－１４０浓度均明显高于正常对照组。两个溶栓组溶栓后再通与未通患者均呈现不同浓度的动态变化。血管再通，则血浆ＧＭＰ－１４０浓度降低，血管未通，血浆ＧＭＰ－１４０浓度升高；阿司匹林对血浆ＧＭＰ－１４０浓度无影响。结论：ＡＭＩ后血小板高度活化，血浆ＧＭＰ－１４０浓度与血栓形成、溶解及再通密切相关；阿司匹林不是抑制血小板活化的理想药物。

Objectives:To evaluate the dynamic variations of platelet activity and its relation to early reperfusion before and after intravenous thrombolytic therapy with urokinase and antiplatelet treatment (aspirin) in patients of acute myocardial infarction (AMI). Methods:Eighty AMI patients who received urokinase intravenously were divided into two groups,40 with thrombolytic therapy,and 40 with thrombolytic therapy and aspirin.The plasma concentrations of alpha granule membrane protein (GMP 140) were determined in each patient before thrombolytic therapy and 2,6,12,24 hours after completion of the urokinase infusion.Early reperfutuon was distinguished by clinical indices (38 cases were determined by coronary arteriography).Dynamic variations of GMP 140 were observed in both reperfution and nonreperfusion patients in two groups.60 healthy individuals were served as controls. Results:The concentrations of GMP 140 after AMI in both groups were significantly higher than those controls. GMP 140 dropped quickly after thrombolytic therapy in reperfusion patients of both groups.If the infarct related arteries of patients were not patent,GMP 140 increased rapidly.There was no significant influence of aspirini on concentrations of GMP 140. Conclusion:The platelets were activated after AMI.Plasma GMP 140 was closely related to thrombosis,thrombolysis and vascular recanalation of AMI.Aspirin was not an ideal drug in inhibiting platelet activation.