介入治疗对急性冠状动脉综合征的血小板活性影响研究

Interventional Therapy in Acute Coronary Syndrome Effects on Platelet Activity

目的探讨经皮冠状动脉介入治疗(PCI)对急性冠状动脉综合征患者血小板活化的影响。方法研究组32例术前服用拜阿司匹林和氯吡格雷,实施PCI;术后皮下注射低分子肝素继续服用拜阿司匹林和氯吡格雷。对照组于造影前同样服用阿司匹林和氯吡格雷。两组患者均于术前30min,研究组于术后2、24、72、96h分别进行了血小板活化指标水平(CD62p、CD63)的检测。结果研究组PCI术后的的血小板活化指标明显高于术前,说明经皮冠状动脉介入治疗能激活血小板的作用;研究组于术后各阶段血液测试,发现血小板活化指标呈抛物线形态,即于是24h以前呈上升趋势,于24h以后逐渐下降,24h时达到峰值,且在术后96h时的测量指标已经恢复术前状态。所有数据经统计学分析具有显著差异(P<0.05)。结论冠心病急性冠状动脉综合征的发生与发展过程中,血小板活化指标变化起到非常重要的作用,利用经皮冠状动脉介入治疗方法,能够明显激活血小板活性因子,易造成血栓形成与血管的再堵塞,因此一方面注意配合抗血小板药物治疗,一方面也需要医学界进一步探讨与研究PCI术控制血小板活性变化的方法。

Objective To observe the changes of platelet activity index CD62p,CD63 before and after percutaneous coronary intervention（PCI） in patients with acute coronary syndrome（ACS）.Methods To collect the blood with all the patients of study group,the collecting time is before PCI and 2,24,72,96 hours after PCI,and to collect the control group＇s blood from their admission.The serum levels of CD62p and CD63were assayed by flow cytometry.Results The serum levels of CD62p,CD63 in study group after PCI increased significantly compared with pre-PCI（P0.05）,and the levels at 2,24,72,hours increased compared with pre-PCI group（P0.05）.The indices peaked at 24 hours and declined from then on.Conclusion Platelet activation plays an important role in the occurrence and development of ACS.We can check the ACS with platelet activation through PCI.So on the one hand we should use the medication of anti-platelet aggregation,and on the other hand we need to deeply research the methods to control platelet activity when PCI.