急性心肌梗死患者血小板活化标志物与超微结构的变化  

Changes of platelet activation markers and platelet ultra-microstructure in the patients with acute myocardial infarction

作　　者：俎德玲[1] 诸葛毅[2] 蒋一鸣 屠晓鸣[1] 周建英[3] 金奇志[1] 程科云[1] 陆国华[3] 郑家胜[1] 杨庆业[1] 高珍艳[1] 

机构地区：[1]衢州市人民医院心血管内科,浙江省衢州324000 [2]浙江衢州学院 [3]浙江大学医学院第一附属医院呼吸科

出　　处：《中华急诊医学杂志》2011年第1期74-77,共4页Chinese Journal of Emergency Medicine

基　　金：浙江省科技厅计划立项资助项目（2007C33010）

摘　　要：目的 探讨急性ST段抬高心肌梗死（STEMI）患者血小板α颗粒糖蛋白（platelet activationdependent granule membrane protein,PADGEM or GMP-140,CD62P）、血小板源生长因子受体αβ亚型（platelet-derived growth factor receptor-αβ,PDGFR-αβ）表达,血小板超微结构的变化.方法 采用流式细胞仪测定36例急性ST段抬高心肌梗死患者和同期34名健康体检者（对照组）外周血中血小板的血小板a颗粒糖蛋白（CD62P）、血小板源生长因子受体αβ亚型（PDGFR-αβ）表达,采用扫描电子显微镜观察血小板超微结构,并进行比较.结果 急性STEMI组治疗前血小板α颗粒糖蛋白、血小板源生长因子受体αβ表达率分别为（3.65±1.87）%,（0.43±0.39）%,治疗后为（0.96±0.79）%,（0.28±0.24）%,对照组相应为（0.67±0.35）%,（0.27±0.22）%.STEMI组的血小板α颗粒糖蛋白、血小板源生长因子受体αβ表达率,治疗前较对照组高（分别为P＜0.01和P＜0.05）,治疗后明显降低.STEMI组扫描电镜观察血小板表而超微结构变化明显.结论 STEMI血小板处于活化状态,血小板活化指标血小板α颗粒糖蛋白可作为冠心病病情监测的有效指标,血小板源生长因子受体αβ有参考价值,扫描电镜观察可发现血小板活化的超微病理结构改变.Objective To investigate the expressions of platelet activation-dependent granule membrane protein and platelet-derived growth factor receptor-αB, and the ultra-microstructure changes of platelets in patients with acute ST-segment elevation myocardial infarction（STEMI）. Method The expressions of platelet activationdependent granule of glycoprotein （CD62P）and platelet derived growth factor receptor αβ subtype （PDGFR-αβ）of platelets in peripheral blood in 36 patients with acute ST-segment elevation myocardial infarction（STEMI） hospitalized and another 34 healthy subjects over the same period （control group） were investigated by flow cytometry and data were analyzed. The changes of ultra microstructure and activity of blood platelets in those patients and control group were observed under the scanning electron microscope. Results The expressions of CD62P and PDGFR-αβin patients with STEMI group before treatment were （3.65 ± 1.87） % and （0.43 ± 0.39） %, respectively, and those after treatment were （0.96 ± 0.79） % and （0.28 ± 0. 24） %, respectively, whereas those in control group were （0.67 ± 0.35） % and （0.27 ± 0.22） %, respectively, which were much lower in control than those in patients with STEMI before treatment （P 〈 0.01 or P 〈 0.05） respectively. There were statistically significant differences in the expressions of CD62P and PDGFR-αβ in patients group between pre-treatment and posttreatment （P 〈0.01 or P 〈0.05）, respectively. Obvious ultra-microstructure changes of platelet surface in patients with STEMI group were observed. Conclusions Due to platelet activation in AMI, the expressions of CD62P can be used as effective indicators for monitoring coronary heart disease, and the PDGFR-αβ can be used as a reference indicator. The platelet surface ultra-microstructure changes during platelet activation in patients with AMI can be found by scanning electron microscopy.

关 键 词：急性心肌梗死 流式细胞术 血小板α颗粒糖蛋白CD62P 血小板超微结构 

分 类 号：R542.22[医药卫生—心血管疾病]