冠心病患者不同治疗阶段GPⅡb/Ⅲa、CD62P状态的变化及临床价值  

Changes of CD62P and GPⅡb/Ⅲa expression in different treatment stages on coronary heart disease patients and its clinical significance

作　　者：蔡裕福[1] 李平[1] 李存仁[1] 杨敏[1] 刘广交[1] 曾俍铭[2] 赖必发[2] 

机构地区：[1]广东省梅州市人民医院心血管内科,514031 [2]广东省梅州市人民医院中心实验室,514031

出　　处：《中华临床医师杂志（电子版）》2014年第24期36-39,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的通过检测GPⅡb/Ⅲa(PAC-1)、血小板膜P选择素(CD62P)探讨冠心病患者不同治疗阶段的血小板活化水平及意义。方法采用流式细胞术(FCM)检测了35例正常对照者(D组)及114例冠心病患者不同治疗时期PAC-1、CD62P的表达。结果冠心病组患者PAC-1、CD62P表达较正常对照组明显升高(P<0.01);冠心病组治疗后,各时期不稳定型心绞痛组(B组)、急性心肌梗死组(C组)和稳定型心绞痛组(A组)对比:B、C组PAC-1、CD62P的表达均较A组高(P<0.05),而B、C组之间两者差别无统计学意义(P>0.05);冠心病(A、B、C)组PCI术后的CD62P、PAC-1的表达较术前明显升高(P<0.01);而术后24 h下降至术前水平,和术前水平相比无统计学意义(P>0.05);但仍高于正常对照组(P<0.05)。结论冠心病患者血小板活化明显增强,不稳定型心绞痛、急性心肌梗死时血小板表面蛋白PAC-1,CD62P的表达进一步的升高,两者的表达可作为血小板功能检测的敏感指标,在冠心病的诊断及监测具有重要的临床意义。Objective The platelet activation markers CD62 P and GPⅡb/Ⅲa were detected at different treatment periods in patients with coronary heart disease（CHD） to explore its significance. Methods PAC-1 and CD62 P were detected by flow cytometry（FCM） in 35 controls and 114 patients with coronary heart disease before and after treatment. Results PAC-1 and CD62 P in CHD group were significantly higher than those in controls（P〈0.01）; Stable angina pectoris（group A） was compared with unstable angina pectoris（group B） and acute myocardial infarction（group C） after different periods of treatment： The expression of PAC-1, CD62 P in group B and group C were higher than group A（P〈0.05）, however, PAC-1 and CD62 P expression were no significant difference between group B and group C（P〉0.05）. Group A, B, C were increased the levels of PAC-1, CD62 P expression after stent implantation（P〈0.01）, and the levels of PAC-1, CD62 P decreased significantly versus their preoperative value after 24 hours, but there were no significant difference（P〉0.05）; The expression of PAC-1, CD62 P were still higher than those in controls after stent implantation（P〈0.05）. Conclusion The platelet activation in CHD patients were in the early stage, its expression were higher when turn to unstable angina pectoris or acute myocardial infarction, PAC-1 and CD62 P expression are the sensitive marker of platelet activation, which helps diagnose and monitor CHD.

关 键 词：冠心病 血小板活化 流式细胞术 双特异性磷酸酶2 P选择素 

分 类 号：R541.4[医药卫生—心血管疾病]