冠心病患者血小板参数的变化及临床意义

Change ,of Platelet Parameters in Patients with Coronary Heart Disease and Its Significance

【目的】分析冠心病患者血小板参数的变化及临床意义。【方法】对100例冠心病患者[61例急性心肌梗死（AMI）和39例心绞痛（AP）]及50例健康人（正常对照组）的血小板四项参数：血小板比容（PCT）、血小板数量（PLT）、血小板体积分布宽度（PDW）、血小板平均体积（MPV）、血小板最大聚集率（PAGM）及血小板活化（CD62p）进行测定，分析其与冠心病之间的联系。【结果】三组间PCT差异无显著性。冠心病患者PLT明显要低于对照组（P〈0．01），而PDW、MPV、PAGM明显高于对照组（P〈0．05）。AMI患者的PDW、MPV、PAGM相对AP组明显偏高（P〈0．05），PLT明显降低（P〈0．05）。CD62p在冠心病患者中的阳性表达明显高于对照组（P〈0．05），AMI患者的CD62p阳性表达明显高于AP组（P〈0．05），Pearson，s相关分析结果显示冠心病患者的CD62p与PAGM、MPV之间具有正相关的关系（r=0．602、0．487，P〈0．05）。【结论】临床上监测血小板参数的变化对冠心痛患者的诊治及预防具有重要意义。

[Objective] To analyze the change of platelet parameters in patients with coronary heart disease and its significance. [Methods]Four platelet parameters including platelet thrombocytocrit （PCT）, platelet count（PLT）, platelet distribution width（PDW） and mean platelet volume（MPV）, platelet maximum aggluti- nation（PAGM） and platelet activation（CD62P） of 61 patients with acute myocardial infarction（AMI）, 39 pa- tients with angina pectoris（AP） and 50 healthy gubjects（control group） were measured. Their relation with coronary heart disease was analyzed. [Results]Compared with control group, there was no significant differ- ence in PCT between AMI patients and AP patients. PLT in AMI patients and AP patients was significantly lower than that in control group（ P 〈0.01）, and PDW, MPV and PAGM were obviously higher than those in control group（ P 〈0.05）. Compared with AP patients, PDW, MPV and PAGM in AMI patients obviously increased（ P 〈0.05）, but PLT obviously decreased（ P 〈0.05）. The positive expression of CD62p in patients with coronary heart diseases was obviously higher than that in control group（ P〈0.05）. The positive expres- sion of CD62p in AMI patients was obviously higher than that in AP group（ P 〈0.05）. Pearson＇s correlation analysis showed that CD62p was positively correlated with PAGM and MPV in patients with coronary heart disease（r=0. 602, 0. 487, P 〈0.05）. [Conclusion] Clinical monitoring of the change of platelet parameters has great significance for the diagnosis, treatment and prevention of patients with coronary heart disease.