外周血白细胞-血小板聚集体在肌钙蛋白阴性的急性冠脉综合症患者和健康人群的分布差异  

Comparison of leukocyte-platelet aggregates in troponin negative acute coronary syndrome patients and healthy subjects

作　　者：葛兰[1,2] 周欣[2] 孙海英[2] 卢芮伊[2] 石蕊[2] 曾山[2] 姜铁民[2] 李玉明[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]武警后勤学院附属医院心脏中心心血管病研究所,天津300162

出　　处：《武警后勤学院学报（医学版）》2013年第4期245-248,F0003,共5页Journal of Logistics University of PAP（Medical Sciences）

基　　金：国家自然科学基金项目(81070121;81170238);天津市自然科学基金项目(09ZCZDSF04200;11JCYBJC12000)

摘　　要：【目的】观察外周血白细胞与血小板形成的聚集体在肌钙蛋白阴性的急性冠脉综合症患者和健康人群的分布情况。【方法】采集2011年11月-2012年5月期间,我中心收治的66例肌钙蛋白阴性的不稳定心绞痛患者外周血,以枸橼酸钠抗凝后采用流式细胞术分别分析粒细胞-血小板、单核细胞-血小板以及淋巴细胞-血小板聚集体的数量和比例。并采用相同方法对51例性别和年龄匹配的健康体检者进行白细胞-血小板聚集体的检测。【结果】与健康体检者相比,冠心病组患者外周血白细胞血小板聚集体的计数显著高于健康对照组[8 162 cells/μl（6 748-12 925）vs.5 911 cells/μl（4 722-7 252）,P〈0.001;以中位数和四分位间距表示,下同]。单核细胞-血小板聚集体百分比较健康对照组明显升高[23.25%（14.01%-40.40%）vs.17.88%（14.23%-24.25%）,P〈0.05],而粒细胞[9.06%（7.15%-11.48%）vs.9.50%（8.14%-11.30%）,P=0.470]和淋巴细胞[7.32%（6.14%-8.94%）vs.7.23%（5.57%-8.03%）,P=0.321]与血小板聚集体百分比在两组间没有显著性差异。【结论】肌钙蛋白阴性的急性冠脉综合症患者外周血白细胞血小板聚集体较健康人群明显升高,其中单核细胞-血小板聚集体增高更为明显,提示单核细胞-血小板聚集体对于冠心病患者危险分层具有潜在应用价值。[Objective]To investigate the distribution of leukocyte-platelet aggregates in patients with troponin negative acute coronary syndrome （ACS） and healthy subjects. [ Methods] During November 2011 to March 2012, 66 individuals with troponin negative ACS and 51 age- and sex-matched healthy control subjects were recruited. Sodium citrate anticoagulated blood was collected from all subjects to quantify the granulocyte-, lymphocyte- and monocyte-platelet aggregates（GPA, LPA, MPA respectively） by flow cytometry. [ Results ] Patients with ACS showed a significant increase in the count of leukocyte-platelet aggregates as compared with the healthy controls [8 162 cells/la, l （6 748 to 12 925） vs. 5 911 cells/ILl （4 722 to 7 252）, P 〈 0.001; presented as median and interquartile range]. The percentage of MPAs was significantly elevated in ACS patients as compared with controls [23.25% （14.01% to 40.40%） vs. 17.88% （14.23% to 24.25%）, P 〈 0.05]. But the difference was not statistically significant between the two groups for the percentage of GPAs [9.06% （7.15% to 11.48%） vs. 9.50% （8.14% to 11.30%）, P= 0.470] and LPAs [7.32% （6.14% to 8.94% ） vs. 7.23%（5.57% to 8.03%）, P = 0.321]. [Conclusions]Our findings suggest that the level of MPAs, but not GPAs and LPAs, increase significantly in the troponin negative ACS patients as compared with the healthy controls. In addition, there is a more severe increase in MPAs in CHD patients, indicating that MPAs may have a potential value in risk stratification for CHD.

关 键 词：冠心病 白细胞-血小板聚集体 单核细胞-血小板聚集体 

分 类 号：R541.4[医药卫生—心血管疾病]