GPⅡb基因型急性心肌梗死患者介入治疗前后GMP-140、vWF和PAI-1水平

GMP-140,vWF and PAI-1 Levels of Acute Myocardial Infarction Patients with Different GPⅡb Genotypes before and after Percutaneous Coronary Intervention

目的:探讨3种血小板膜糖蛋白(GP)Ⅱb HPA-3基因型急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)前后血浆中血小板α-颗粒膜蛋白(GMP-140)、血管性血友病因子(vWF)和纤溶酶原激活物抑制物-1(PAI-1)变化。方法:对102例AMI患者进行GPⅡb HPA-3基因分型,比较各基因型AMI患者的临床特征,并测定PCI术前、术后即刻及术后24 h 3个时间点血浆GMP-140、vWF和PAI-1水平。结果:102例AMI患者中,GPⅡb HPA-3 aa基因型34例,ab基因型38例,bb基因型30例,3种基因型AMI患者的临床特征比较无统计学意义;3种基因型AMI患者GMP-140在PCI术后开始增高(P<0.01),术后24 h下降,bb基因组在PCI术后即刻、术后24 h较aa、ab基因组均增高(P<0.01);vWF在PCI术后即刻、术后24 h(P<0.01)持续增高,但3种基因组间差异无统计学意义;PAI-1在术后即刻、术后24h持续升高,bb基因组在术后即刻、术后24 h活性明显高于aa、ab基因组(P<0.01)。结论:GPⅡb HPA-3基因型AMI患者PCI前后血浆GMP-140、vWF和PAI-1水平发生变化,尤其bb基因型在PCI术后存在更明显的血小板活化。

Objective：To investigate the changes of platelet alpha granule membrane protein （GMP-140）,yon willebrand factor （vWF） and plasminogen activator inhibitor-1 （PAI-1） levels in acute myocardial infarction （AMI） patients with different platelet membrane glycoprotein （GP） IIb HPA-3 gene before and after percutaneous coronary intervention （PCI）.Methods：（GP） Ⅱb HPA-3 genotyping was carried out in 102 AMI patients,the clinical characteristics of patients with different genotypes were compared,and GMP-140,vWF and PAI-1 levels were determined before PCI,immediately after PCI and in 24h after PCI.Results：There were 34 patients with aa genotype,38 with ab genotype and 30 with bb genotype.There was no significant difference in the clinical characteristics of patients with different genotypes; The GMP-140 levels in the three genotype groups increased immediately after PCI and decreased in 24 h after PCI,the GMP-140 levels in bb genotype group were remarkably higher immediately after PCI and in 24 h after PCI than those of the other two genotype groups （P 〈 0.01） ; The vWF levels continuously increased immediately after PCI and in 24 h after PCI in the three groups,and there was no significant difference among the three genotype groups; The PAI-1 levels continuously in=creased immediately after PCI and in 24 h after PCI in the three groups,the PAI-1levels in bb genotype group were remarkably higher immediately after PCI and in 24 h after PCI than those of the other two genotype groups （P 〈 0.01）.Conclusion：GMP-140,vWF and PAI-1 levels change in AMI patients after PCI,platelet activation is more remarkable in patients with bb genotype in GP Ⅱ b HPA-3 than that in those with other genotypes.