高龄ST段抬高型心肌梗死患者残余血小板活化与趋化因子CCL2相关性分析

Correlation analysis of residual platelet activation and chemokine CCL2 in elderly patients with ST-elevation myocardial infarction

目的探讨高龄ST段抬高型心肌梗死(STEMI)患者服用氯吡格雷后残余血小板活化与趋化因子CCL2的相关性。方法选取自2018年8月至2019年4月北部战区总医院收治的高龄STEMI患者60例为研究对象。采用Verifynow法检测P2Y12反应单位(PRU),根据数值不同,将患者分为残余血小板高反应组(高反应组,n=27)和残余血小板正常反应组(正常反应组,n=33)。采用酶联免疫吸附法检测患者血浆CCL2浓度。采用Pearson相关性分析评估患者血浆CCL2浓度与PRU值间的关系。结果服用氯吡格雷后4~6 h,残余血小板高反应患者比例为45.0%(27/60)。两组患者临床一般资料比较,差异均无统计学意义(P>0.05)。服用氯吡格雷后4~6 h,高反应组患者血浆中CCL2浓度为(253.20±60.38)pg/ml,明显高于正常反应组的(197.70±48.20)pg/ml,差异有统计学意义(P<0.05)。血浆中CCL2浓度与PRU之间存在线性关系(r=0.462,P<0.05)。结论高龄STEMI患者残余血小板的聚集和活化与CCL2相关。

Objective To investigate the correlation between residual platelet activation and chemokine CCL2 in elderly patients with ST-elevation myocardial infarction(STEMI)after clopidogrel administration.Methods A retrospective study was performed on 60 cases of patients with STEMI who were admitted from August 2018 to April 2019.P2 Y12 response units(PRU)were detected by Verifynow method.According to different values,patients were divided into the high response group with residual platelets(high response group,n=27)and the normal response group with residual platelets(normal response group,n=33).Plasma CCL2 concentration was determined by Elisa.Pearson correlation analysis was used to evaluate the relationship between plasma CCL2 concentration and PRU value.Results The percentage of patients with high residual platelet response was 45.0%(27/60)after 4-6 hours of clopidogrel administration.Comparison of general clinical data between the two groups showed no statistically significant difference(P> 0.05).After taking clopidogrel for 4-6 hours,the plasma CCL2 concentration in the high-response group was(253.20±60.38)pg/ml,which was significantly higher than that in the normal response group(197.70±48.20)pg/ml,and the difference was statistically significant(P<0.05).There was a linear relationship between PLASMA CCL2 concentration and PRU(r=0.462,P<0.05).Conclusion Aggregation and activation of residual platelets in elderly STEMI patients are associated with CCl2.