冠心病患者血小板聚集功能与疾病严重程度及生化指标关系的研究  

Research on relationship among platelet aggregation function,disease severity and biochemical indexes in patients with coronary heart disease

作　　者：李玉敏[1] 齐振生[2] 姚淑艳[1] 张颖[3] 吉向军 邢佳侬 LI Yumin;QI Zhensheng;YAO Shuyan;ZHANG Ying;JI Xiangjun;XING Jianong(Department of Clinical Laboratory;Department of Paediatrics;Department of Endocrinae,Tangshan No.3 Hospital,Tangshan,Hebei 063000,China;Department of Cardiology,Tangshan GuyeChinese Medical Hospital,Tangshan,Hebei 063000,China;Department of Cardiology,Tangshan No.3 Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第三医院检验科,河北唐山063000 [2]唐山市第三医院儿科,河北唐山063000 [3]唐山市第三医院内分泌科,河北唐山063000 [4]唐山市古冶区中医院心内科,河北唐山063000 [5]唐山市第三医院心内科,河北唐山063000

出　　处：《国际检验医学杂志》2019年第14期1709-1712,1716,共5页International Journal of Laboratory Medicine

基　　金：河北省卫生计生委立项课题(20181298)

摘　　要：目的 探讨冠心病患者血小板聚集功能在不同临床分型、不同冠脉病变支数水平变化及与同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)相关性。方法 回顾性分析唐山市第三医院首次确诊的冠心病患者152例,按照冠状动脉造影结果将冠心病患者分为单支病变组和多支病变组;再按应激状态分为急性冠脉综合征(ACS)组和非ACS组,分析以二磷酸腺苷(ADP)和花生四烯酸(AA)为诱导剂的血小板聚集功能在各组间的变化,探讨其与Hcy、hs-CRP的相关性。结果 单支病变组和多支病变组以ADP和AA为诱导剂的最大血小板聚集率比较差异均无统计学意义( P >0.05);ACS组与非ACS组以ADP和AA为诱导剂的最大血小板聚集率比较差异均有统计学意义( P <0.05);冠心病患者hs-CRP、Hcy水平与AA、ADP诱导的最大血小板聚集率呈显著的正相关( r 1=0.29、0.33;r 2=0.37、0.34, P <0.05)。结论 最大血小板聚集率在ACS、非ACS患者中呈现不同的变化且与hs-CRP、Hcy密切相关,对冠心病的诊断、治疗、危险评估有一定的参考价值。Objective To investigate the relationship among platelet aggregation function in patients with coronary heart disease(CHD) in different clinical types,changes in the coronary branch number and risk factors such as homocysteine(Hcy) and hypersensitive C-reactive protein(hs-CRP). Methods Retrospective analysis of 152 patients with coronary heart disease diagnosed for the first time in Tangshan No.3 Hospital.The selected coronary heart disease patients were divided into single branch and multiple branch lesions according to the results of coronary angiography.In addition,according to the stress state,it was divided into acute coronary syndrome(ACS)and non-acute coronary syndrome(non-ACS)groups.The platelet aggregation function of adenosine diphosphate (ADP) and arachidonic acid(AA) as inducers was analyzed to compare difference between groups.To investigate the correlation among the platelet aggregation function,Hcy and hs-CRP. Results There was no significant difference in the maximum platelet aggregation rate of adenosine ADP and AA in single branch lesions group and multiple branch lesions group( P >0.05);The difference in the maximum platelet aggregation between the acute coronary syndrome group and the non-acute coronary syndrome group ADP and AA was statistically significant( P <0.05);hs-CRP and Hcy levels were positively correlated with the maximum platelet aggregation rate induced by AA and ADP( r 1=0.29,0.33;r 2= 0.37 , 0.34 , P <0.05). Conclusion The maximum platelet aggregation rate in ACS,non-ACS showed different changes,which is closely related to hs-CRP and Hcy.It may be of reference value for diagnosis,treatment and risk assessment of coronary heart disease.

关 键 词：最大血小板聚集率 冠心病 同型半胱氨酸 超敏C反应蛋白 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]