冠心病患者循环活化血小板的改变及阿斯匹林抵抗的处理

The Changes of CAP and the Management of Aspirin Resistance in CHD Patients

目的 探讨冠心病患者循环活化血小板 (CAP)的变化及对阿斯匹林抵抗的处理。方法 以纤维蛋白原受体 (PAC - 1)、P -选择素 (CD6 2P)作为分子标志物 ,FCM三色免疫荧光分析CAP ,观察正常人及冠心病患者CAP变化。结果 正常人静止血小板膜表面PAC - 1和CD6 2P表达较低。冠心病患者血液中表达PAC - 1的数量与正常人比较有非常显著差异 (P <0 0 0 1)。阿斯匹林治疗后冠心病患者的PAC - 1及CD6 2P表达呈下降趋势 (P值分别为 <0 0 0 1及 <0 0 5)。抵克力特可显著降低存在阿斯匹林抵抗现象的病人PAC - 1的表达 (P <0 0 0 1)。结论 冠心病患者血液中PAC- 1明显增高 ,阿斯匹林可以显著降低冠心病患者PAC - 1及CD6 2P的表达水平。抵克力特可显著降低存在阿斯匹林抵抗现象的病人PAC -

Objective To explore the clinical signi fi cance of CAP changes and the management of aspirin resistance in CHD patients.Methods Study included 103 CHD patients and 35 healthy pe ople.PAC-1 and CD62P as the molecular markers of CAP were analyzed by FCM 3-colo r immunofluorescence.PAC-1 and CD62P were measured in all study objects.Results The quantity of PAC-1 in 103 CHD patients is significan tly higher than that in normal people( P <0 001).The expression of PAC-1 and CD62P of CAP decreased significantly( P <0 001 and P <0 05,respectivel y) after aspirin treatment in CHD patients.Ticlopidine can dramatically reduce t he expression of PAC-1 in CHD patients with aspirin resistance ( P <0 001). Conclusions The expression of PAC-1 and CD62P in CHD pa tients obviously increased.Aspirin can significantly dicrease the level of PAC-1 and CD62P in CHD patients.Ticlopidine can dramatically reduce the expression of PAC-1 in CHDpatients with aspirin resistance.