急性心肌梗死患者外周血中嗜酸性粒细胞和血小板数量变化的意义

Significance of Eosinophils and Platelets in Peripheral Blood in Patients with Acute Myocardial Infarction

目的观察急性心肌梗死(acute myocardial infarction,AMI)患者外周血中嗜酸粒细胞和血小板数量的变化,探讨嗜酸粒细胞(eosinophils,EOS)在AMI发生发展中的作用。方法选择北京天坛医院2013-11月/2014-05月入院治疗的冠心病患者100例,包括50例急性ST段抬高心肌梗死(STEMI)患者和50例性别年龄与之匹配的稳定型冠心病(stable angina pectoris,SAP)患者。测定所有患者外周血EOS数量和百分比、血小板(platelet,PLT)计数和平均血小板体积(mean PLT volume,MPV)。结果 AMI患者外周血中EOS计数和百分比显著低于SAP组(P<0.01),与SAP组相比,AMI患者PLT/体质量比较高,但未达到统计学差异;在AMI患者中,肌钙蛋白I≥20 ng/ml患者的EOS数量显著低于肌钙蛋白I<20 ng/ml的患者(P<0.05)。EOS计数及百分比和肌钙蛋白I之间有显著的负相关(r=-0.474,P<0.01;r=-0.520,P<0.01,Pearson相关性)。结论 STEMI患者外周血中EOS数量明显减少,EOS百分比和肌钙蛋白I之间存在负相关,EOS数量减少可能提示更严重的心肌损伤,EOS可能在血栓形成中发挥着重要作用。

Objective To investigate the significance of platelet （PLT） and eosinophils （EOS） in coronary arterial thrombi, and to assess the PLT count, mean PLT volume （MPV）, EOS count and percentage in peripheral blood of pa- tients with acute myocardial infarction （AMI） and angina pectoris （AP）.Methods EOS were checked by hematoeylin-eo- sin （HE） staining. PLT count, MPV, PLT mass and EOS percentage were determined in 50 patients with AP and 50 pa- tients with AMI.Results Patients with AMI had significantly lower EOS counts and percentages than those of patients with AP （both P^0.01）. A higher PLT counts was observed in AMI cases compared with AP cases.The patients with troponin I more than 20 ng/ml had a significant lower EOS percentage than those who troponin I was less than 20 ng/ml （P%0.05） and showed decreased levels of both EOS percentage and PLT count.Moreover, there was a significant inverse correlation between EOS percentage and Troponin I （r = -0.474, P〈0.01 ;r = -0.520, P〈0.01, Pearson Correlation）. Conclusion Patients with myocardial infarction have dramatically decreasing of EOS percentage and increasing of PLT count. And the decreased EOS percentage suggests a serious myocardial damage. EOS plays an important role in the thrombosis in the patients with AMI.