急性冠脉综合征患者血小板蛋白酶活化受体-1的表达  

Expressions of platelet protease activated receptor-1 in patients with acute coronary syndrome

作　　者：覃月秋[1] 楚罗湘[1] 高艳[1] Qin Yueqiu;Chu Luoxiang;Gao Yan(The Fourtk Affiliated Hospital of Guangxi Medical Universit y,Liuzkou 545005,Guangx)

机构地区：[1]广西医科大学第四附属医院,广西柳州545005

出　　处：《右江民族医学院学报》2018年第2期112-115,共4页Journal of Youjiang Medical University for Nationalities

基　　金：国家自然基金资助项目(81160030)

摘　　要：目的观察急性冠脉综合征(ACS)患者血小板蛋白酶活化受体-1(PAR-1)的表达,为探讨多种途径抗血小板聚集治疗提供依据。方法临床研究共纳入150例研究对象,分为急性ST段抬高型心肌梗死(STEMI组)、急性非ST段抬高型心肌梗死(NSTEMI组)、不稳定型心绞痛1组(UA-1组,任何一支血管狭窄≥75%)、不稳定型心绞痛2组(UA-2组,50%≤任何一支血管狭窄<75%)、对照组(Cont组,冠脉造影、心肌酶谱正常),每组30例。通过ELISA方法检测富血小板血浆PAR-1的表达。结果 Cont组、UA-2组、UA-1组、NSTEMI组、STEMI组的PAR-1浓度依次逐渐升高,分别为(2.35±0.10)ng/ml、(2.66±0.14)ng/ml、(2.85±0.17)ng/ml、(3.81±0.15)ng/ml、(3.95±0.24)ng/ml,各组总体比较差异有统计学意义(F=182.869,P<0.001),5个研究组组间两两比较结果显示,除STEMI和NSTEMI组间、UA-1和UA-2组间比较差异无统计学意义(P>0.05),其余急性心肌梗死各组(STEMI、NSTEMI组)与心绞痛各组(UA-1、UA-2组)两两比较差异有统计学意义(P<0.001,P<0.01或P<0.05),ACS各组与对照组比较差异均有统计学意义(P<0.001)。结论 ACS患者血小板PAR-1表达明显增加,PAR-1通路激活可能是ACS发生的始动因素,因此适当抑制PAR-1表达或许成为抗血小板聚集治疗新的有效靶点。Objective To observe the expressions of platelet protease activated receptor-1（PAR-1）in patients with acute coronary syndrome（ACS）and provide evidences for exploring various ways of antiplatelet aggregation therapy. Methods A total of 150 patients were selected as the clinical study objects and were divided into acute ST-segment elevation myocardial infarction（STEMI）group,acute non-ST-segment elevation myocardial infarction（NSTEMI）group,unstable angina（UA）-1 group（any one of the vessel branch stenosis≥75%）,UA-2 group（50%≤any one of the vessel branch stenosis〈75%）and control group（Cont group：normal coronary arteriogram and myocardial enzymogram）,30 cases in each group.The expression of PAR-1 in platelet-rich plasma was detected by ELISA. Results The concentrations of PAR-1 in Cont group,UA-2 group,UA-1 group,NSTEMI group and STEMI group gradually increased in turn,and they were（2.35±0.10）ng/ml,（2.66±0.14）ng/ml,（2.85±0.17）ng/ml,（3.81±0.15）ng/ml and（3.95±0.24）ng/ml respectively,and the overall comparison of PAR-1 among the five groups showed that there were statistically significant differences（F =182.869,P〈0.001）.As for the results of two groups comparison,except the comparisons of PAR-1 between the STEMI and NSTEMI groups,and between the UA-1 and UA-2 groups showed no statistically significant differences（P〈0.05）,the differences between acute myocardial infarction groups（STEMI,USTEMI group）and angina groups（UA-1,UA-2 group）were statistically significant（P〈0.001,P〈0.01 or P〈0.05）,the differences between the ACS groups and the control group were statistically significant（P〈0.001）. Conclusion The expression of platelet PAR-1 in ACS patient is significantly increased,and PAR-1 pathway activation may be the initiating factor in the occurrence of ACS.So proper inhibition of PAR-1 expression may be a new effective target for antiplatelet aggregation therapy.

关 键 词：急性冠脉综合征 蛋白酶活化受体-1 抗血小板聚集 

分 类 号：R331.124[医药卫生—人体生理学]