介入治疗对老年急性冠状动脉综合征患者血小板活化和炎症因子的影响

Effects of percutaneous coronary intervention therapy on platelet activation and inflammatory factors in elderly patients of acute coronary syndrome

目的探讨经皮冠状动脉介入(PCI)治疗对老年急性冠状动脉综合征(ACS)患者血小板活化和炎症因子的影响。方法 68例经PCI治疗的老年ACS患者,在术前、术后次日、术后1周及术后4周清晨分别空腹抽肘静脉血测定P选择素(CD62P)、GPⅡb/Ⅲa受体复合物、血浆纤维蛋白原(Fg)及血清高敏C反应蛋白(hs-CRP)水平。并选择44例健康体检者作正常对照组。结果 CD62P、GPⅡb/Ⅲa、Fg、hs-CRP水平ASC患者PCI手术前后均较正常对照组增高(P<0.05),CD62P、GPⅡb/Ⅲa、Fg、hs-CRP水平手术前后在不同冠状动脉病变组间差异无统计学意义(P>0.05)。结论老年ACS患者存在血小板活化和炎症反应,CD62P、GPⅡb/Ⅲa、Fg、hs-CRP水平在术后4周内增高,术后4周内的抗血小板及抗凝治疗对防治PCI术后冠状动脉内血栓形成及再狭窄至关重要。

Objective To study the effects of percutaneous coronary intervention(PCI) therapy on platelet activation and inflammatory factors in elderly patients with acute coronary syndrome(ACS). Methods Sixty-eight elderly ACS patients with PCI therapy and 44 healthy controls were enrolled.Fasting venous blood were collected to determine the expression of CD62P,receptor complex of glucose protein Ⅱb/Ⅲa(GPⅡb/Ⅲa),plasma fibrinogen(Fg) and serum high-sensitivity C-reactive protein(hs-CRP) befor PCI and 1st,7th and 28th morning after PCI. Results Significant increase of CD62P,GPⅡb/Ⅲa,Fg and hs-CRP were revealed in ACS patients than those in the controls(P<0.05).However,there was no significant difference in these parameters among patients with different Gensini scores(P>0.05). Conclusion PCI can activate the platelet and inflammatory reaction.Therefore,antiplatelet and antithrombotic management,especially within 4 weeks after PCI,is critical for prevention of coronal thrombosis and restenosis. WT5'HZ〗