急性心肌梗死患者血小板膜凝血酶敏感蛋白及糖蛋白Ⅳ的分布

Distribution of platelet membrane glycoprotein Ⅳ= and thrombospondin in patients with acute myocardial infarction

目的:探讨急性心肌梗死(AMI)后患者血小板膜表面凝血酶敏感蛋白(TSP)及糖蛋白Ⅳ(GPⅣ)分布状况。方法:用流式细胞仪测定AMI患者(10例)静息状态时及凝血酶(0．1U/ml,0．5 U/ml)激活时,血小板膜表面TSP及 GPⅣ分布状况,并与正常人(12 名)进行比较。结果:AMI 12－72 h,静息血小板和激活血小板膜表面TSP及GPⅣ均明显高于正常人(P＜0．05,P＜0．001);AMI 168 h激活血小板膜 TSP及 GPⅣ高于正常人(P＜0．05,P＜0．01),静息血小板膜TSP及GPⅣ与正常人差异无显著性(P＞0.05)。AMI静息血小板和激活血小板膜TSP与GPⅣ呈显著正相关(r＝0.383,P＜0.001)。结论:AMI发生后72h内血小板活性及反应性明显增高,血小板反应性持续增高达AMI后168h。

Aim: To investigate the glycoprotein Ⅳ (GP Ⅳ ) and thrombospondin(TSP) levels on the membrane surface of platelets in patients with acute myocardial infarction( AMI). Methods: On the membrane surface of the stationary platelet or activated platelet, GP Ⅳ and TSP levels in the AMI patients ( n = 10) were measured with a washed platelet flowcytometric assay and compared with those of the healthy(n = 12). Results: The GP Ⅳ ,and TSP levels of the stationary activated platelets during 12 -72 h in the patients after AMI were significantly higher than those in the healthy( P < 0.05 and P < 0.001 respectively) .At the 168th h after AMI, the GP Ⅳ and TSP levels of activated platelets in patients with AMI were also significantly higher than those of the healthy (P<0.05, P<0.01) . The GP Ⅳ was positively correlated with the TSP on platelets surface in AMI patients (P < 0.01, P < 0.001). Conclusions: The activity and reaction to thrombin of platelets increase in patients with AMI during 12-72 h, and the reaction increases in patients during 168 h after AMI.