冠心病患者阿司匹林抵抗与血小板膜糖蛋白CD62p及GPⅡb／Ⅲa相关性的研究  

Relationship between aspirin resistance and platelet membrane glycoprotein CD62p as well as GPⅡb/Ⅲa in patients with coronary heart disease

作　　者：陈世德[1] 伍伟锋[1] 刘唐威[1] 秦雪[2] 韦斌[1] 

机构地区：[1]广西医科大学第一附属医院心内科,南宁530021 [2]广西医科大学第一附属医院临床医学实验中心

出　　处：《临床心血管病杂志》2008年第5期357-359,共3页Journal of Clinical Cardiology

基　　金：广西科学基金项目(桂科青No:0447031);教育部“春晖计划”科研合作项目(No:Z2005-1-45001)

摘　　要：目的:观察冠心病(CHD)患者阿司匹林治疗前后血小板膜糖蛋白CD62p和GPⅡb/Ⅲa的变化,探讨其与阿司匹林抵抗(AR)的关系。方法:采用流式细胞术检测60例CHD患者(CHD组)及20例健康人(对照组)的血小板CD62p、GPⅡb/Ⅲa表达的阳性率。根据血小板聚集率(PAG)将CHD组分为AR亚组和阿司匹林敏感亚组(AS亚组)。60例CHD患者接受阿司匹林(100mg,qd)等治疗,2周后复检CD62p、GPⅡb/Ⅲa,并采用比浊法分别测定由二磷酸腺苷(ADP)、花生四烯酸(AA)诱导的PAG。结果:CHD患者治疗后血小板CD62p、GPⅡb/Ⅲa表达阳性率均比治疗前明显降低(P<0.01),但仍高于对照组(P<0.01)。入选60例CHD患者中有8例(13.3%)存在AR。AR亚组血小板GPⅡb/Ⅲa表达阳性率高于AS亚组(P<0.01)。结论:GPⅡb/Ⅲa可作为CHD患者阿司匹林治疗中早期识别AR的指标之一。Objective：To investigate the changes of platelet membrane glycoprotein CD62p and GP Ⅱb/Ⅲa in aspirin-treated patients with coronary heart disease （CHD）, and to explore the relationship between CD62p or GP Ⅱb/Ⅲa and aspirin resistance （AR） in CHD patients. Method： CD62p-positive or GP Ⅱb/Ⅲa-positive platelets were detected by flow cytometry （FCM） in 60 patients with CHD （CHD group） and in 20 normal controls （NC group） before treatment. CHD patients took aspirin 100mg/d for two weeks. After treatment, CD62p-positive or GP Ⅱb/Ⅲa-positive platelets in patients were detected by FCM again. Platelet aggregation （PAG） induced with adenosine diphosphate （ADP） and arachidonic acid （AA） were detected. According to PAG, CHD group was divided into two subgroups： aspirin-resistant subgroup and aspirin-sensitive subgroup. Result： The numbers of CD62p-positive or GP Ⅱb/Ⅲa-positive platelets in patients with CHD were significantly declined after aspirin treatment （P〈0.01）, but still higher than those of normal controls（P〈0.01）. Aspirin-resistant were found in 8 （13.3%） patients and 52 （86.7%） patients were aspirin-sensitive. The numbers of GP Ⅱb/Ⅲ a-positive platelets in aspirin-resistant subgroup were higher than those in aspirin-sensitive subgroup （P〈0. 01）. Conelusion：GPⅡb/Ⅲa may be used as one of platelet activation markers to evaluate AR in CHD patients treated with aspirin.

关 键 词：冠状动脉疾病 阿司匹林抵抗 流式细胞术 血小板膜糖蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]