P2X_1受体介导的血小板活化与急性冠脉综合征的相关性研究

Correlation between platelet activation mediated by platelet membrane P2X_1 receptor and acute coronary syndrome

目的探讨P2X1受体介导的血小板活化与急性冠脉综合征(ACS)的关系及临床意义。方法选取70例ACS患者,其中急性心肌梗死(AMI)患者30例,不稳定型心绞痛(UA)患者40例,同期入院的健康受试者20例作为对照组。受试者均给予口服阿司匹林150 mg和氯吡格雷75 mg治疗,在服药前及服药后24 h抽取静脉血进行血小板检测。分别以α,β-me ATP(3μM)、低浓度胶原(1μg/mL)激活血小板,以Fluo-3,AMester为标记物在荧光分光光度计下观察血小板钙离子水平变化及应用酶联免疫吸附法(ELISA)测定血小板P-选择素、血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb/Ⅲa)水平的变化。结果 ACS组患者血小板钙离子、P-选择素及GPⅡb/Ⅲa基线水平均高于对照组(P<0.05),抗血小板治疗后ACS组及对照组患者血小板钙离子、P-选择素及GPⅡb/Ⅲa水平均较治疗前水平降低(P<0.05),但ACS组患者血小板钙离子、P-选择素及GPⅡb/Ⅲa水平下降幅度低于对照组(P<0.05)。AMI组血小板钙离子基线水平高于UA组(P<0.05),抗血小板治疗后AMI组与UA组的血小板钙离子浓度下降幅度有统计学差异(P<0.05)。结论 ACS患者血小板膜P2X1受体处于高活化状态,抗血小板治疗可以抑制血小板膜P2X1受体的激活。

Objective To investigate the correlation between platelet activation mediated by platelet membrane P2X1 receptor and acute coronary syndrome（ACS） and the clinical significance.Methods Among 70 ACS patients,there were 30 with acute myocardial infarction（AMI group） and 40 with unstable angina（UA group）,and other 20 health people were selected as control group.All patients were given oral aspirin（150 mg） and clopidogrel（75 mg） as antiplatelet treatment.The venous blood samples were collected for detecting platelet before and 24 hours after taking drugs.The changes of platelet calcium ion（Ca2＋） were observed by using fluorospectrophotometer taking Fluo-3,AM ester as markers after activating platelet respectively with α,β-me ATP（3 μM） and low-concentration collagen（1 μg/mL）.The changes of levels of platelet P-selectin and platelet membrane glycoprotein Ⅱb/Ⅲa（GPⅡb/Ⅲa） were detected by using ELISA.Results The datum levels of platelet Ca2＋,P-selectin and GPⅡb/Ⅲa were higher in AMI group and UA group than those in control group（P0.05）.After antiplatelet treatment,the levels of platelet Ca2＋,P-selectin and GPⅡb/Ⅲa decreased in AMI group,UA group and control group than before the treatment（P0.05）,but their reducing amplitudes were lower in AMI group,UA group than those in control group（P0.05）.The datum level of platelet Ca2＋ was higher in AMI group than that in UA group（P0.05）,and after antiplatelet treatment,its reducing amplitude was statistically significant in AMI group and UA group（P0.05）.Conclusion Platelet membrane P2X1 receptor is in an overactivity condition in ACS patients,and antiplatelet treatment can inhibit its activation.