冠心病患者血小板单核细胞聚集体及高敏C反应蛋白水平的变化

Changes of Platelet-monocyte Aggregation and C-reactive Protein in Serum of Patients with Coronary Artery Disease

【目的】探讨血小板单核细胞聚集体[-PMA（CD61／CD14）]及高敏C反应蛋白（hs—CRP）在冠心病（CHD）发生、发展中的作用。【方法】选择90例CHD患者[包括急性心肌梗死（AMI组）30例、不稳定型心绞痛（UAP组）30例、稳定型心绞痛（SAP组）30例]及30例健康体检者（对照组），采用三色全血流式细胞术测定外周血中血小板CD61／CDl4的表达水平，采用免疫透射比浊法测定hs—CRP水平。【结果】AMI组、UAP组、sAP组患者PMA的表达水平分别为[（32．15士11．03），（27．94±8．61），（19．85±7．39）％]，显著高于正常对照组[（10．39±3．67）％]（P〈O．01，P〈O．05）；且AMI组、UAP组患者PMA的表达水平[（32．15±11．03），（27．94±8．61）％]，明显高于sAP组患者[（19．85±7．39）％]（均P〈0．01）；AMI组、uAP组、sAP组患者hs—CRP水平分别为[（31．74±15．53），（29．19±7．17），（14．25±7．36）mg／L]，显著高于正常对照组[（2．85±2．63）mg／L]（均P〈0．01）；且AMI组、UAP组患者hs—CRP水平[（31．74±15．53），（29．19±7．17）mg／L]，明显高于SAP组患者r（14．25±7．36）mg／L]（均P〈o．01）；AMI组和UAP组患者PMA、hs—CRP两指标均无显著差异（均P〉0．05）。【结论】CHD患者血小板明显活化，hs—CRP参与了CHD炎症反应，hs-CRP、PMA在冠状动脉粥样硬化发生及发展中起重作用，监测其水平变化对于CHD的诊断、病情判断以及预后评估均有重意义。

[Objective]To explore the role of platelet activation markers PMA（CD61/CD14） and high sensitive C-reactive protein（hs-CRP） in the occurrence and development of coronary heart disease（CHD）. [Methods]Totally 90 CHD patients including 30 patients with acute myocardial infarction（AMI group）, 30 patients with unstable angi- na（UAP group） and 30 patients with stable angina （SAP group） were chosen.. Triad color flow cytometry was used to detect the expression of platelet CD61/CD14 in peripheral blood, and immune turbidimetry was used to de- tect the level of hs-CRP. [Results]The expressions of PMA in AMI group, UAP group and SAP group were Signif- icantly higher than those in control group（ P 〈0.01, P 〈0.05）, and the expressions of PMA in AMI group and UAP group were significantly higher than those in the SAP group（all P 〈0. 01）. The levels of hs-CRP in AMI group, UAP group and SAP group were significantly higher than those in control group（ P 〈0.01）, and the levels of hs-CRP in AMI group and UAP group were significantly higher than those in SAP group（ P 〈0.01）. There was no significant difference in the expression of PMA and the levels of hs-CRP between AMI group and UAP group（ P 〉0.05）. [Conclusion]The platelet activation is obvious in CHD patients, and hs-CRP participates in the inflamma- tory reaction of CHD. PMA and hs-CRP play an important role in the occurrence and development of CHD. By mo- nitoring the level change of PMA and hs-CRP, there will be important significance to the condition judgment and prognosis evaluation in CHD patients.