非ST段抬高型急性心肌梗死患者经皮冠状动脉介入治疗术后高残留血小板活性与血小板表面Ⅱb/Ⅲa受体、P-选择素及预后的关系  

Relationship between high residual platelet activity and Ⅱb/Ⅲa receptor,P-selectin on platelet surface,prognosis in patients with non ST segment elevation acute myocardial infarction after PCI

作　　者：刘军[1] 贾志[1] 霍立巍 LIU Jun;JIA Zhi;HUO Liwei(Internal Medicine-Cardiovascular Department,Tianjin Beichen Hospital,Tianjin 300400,China)

机构地区：[1]天津市北辰医院心内科,天津300400

出　　处：《实用医学杂志》2022年第8期934-937,共4页The Journal of Practical Medicine

基　　金：天津市北辰区科技发展计划项目(编号:2018-SHGY-15)。

摘　　要：目的研究非ST段抬高型急性心肌梗死(NSTEMI)经皮冠状动脉介入治疗(PCI)后高残留血小板活性(HRPR)与血小板表面Ⅱb/Ⅲa受体、P-选择素及预后的关系。方法选取行PCI治疗的NSTEMI患者214例。根据患者的血小板聚集率分为HRPR组和LRPR组。检测血小板表面Ⅱb/Ⅲa(PAC-1)及P^(-)选择素(CD62p)的水平。随访1年统计缺血事件发生情况。结果HRPR组PAC-1^(+)/CD62p^(+)、PAC-1^(-)/CD62p+、PAC-1^(+)/CD62p^(-)血小板水平高于LRPR组(P<0.05)。血小板聚集率水平与PAC-1^(+)/CD62p^(+)、PAC-1^(+)/CD62p-呈正相关(P<0.05)。PAC-1预先孵育血小板后,血小板聚集率明显降低(P<0.05);抗CD62p抗体预先孵育血小板后,血小板聚集率并无明显变化(P>0.05)。HRPR组缺血事件发生率高于LRPR组(P<0.05)。结论NSTEMI患者PCI术后HRPR与血小板表面Ⅱb/Ⅲa受体有关,与P-选择素无关,HRPR可增加患者缺血事件发生的风险。Objective o investigate the relationship between high residual platelet activity and Ⅱb/Ⅲa receptor,P-selectin on platelet surface,prognosis in patients with non ST segment elevation acute myocardial infarction(NSTEMI)after percutaneous coronary intervention(PCI).Methods A total of 214 patients with NSTEMI receiving PCI were selected.According to the platelet aggregation rate,they were divided into HRPR group and LRPR group.The level of Ⅱb/Ⅲa receptor(PAC-1)and P-selectin(CD62p)on the platelet surface were measured.All patients were followed up for one year to count the occurrence of ischemic events.Results The levels of PAC-1^(+)/CD62P^(+),PAC-1^(-)/CD62P^(+),PAC-1^(+)/CD62P^(-)platelets in HRPR group were higher than those in LRPR group,the difference was statistically significant(P<0.05).The platelet aggregation rate was positively correlated with the levels of PAC-1^(+)/CD62P^(+),PAC-1^(+)/CD62P^(-)(P<0.05).When platelets were pre incubated with PAC-1,the platelet aggregation rate was decreased significantly(P<0.05).When platelets were pre incubated with anti-CD62p antibody,there was no significant change in platelet aggregation rate(P>0.05).The incidence of ischemic events in HRPR group was higher than that in LRPR group(P<0.05).Conclusion HRPR in NSTEMI patients after PCI was related to Ⅱb/Ⅲa receptor on platelet surface,but it's not related to P-selectin.HRPR could increase the risk of ischemic events in patients.

关 键 词：非ST段抬高型急性心肌梗死 高残留血小板活性 Ⅱb/Ⅲa受体 P-选择素 缺血事件 

分 类 号：R542.22[医药卫生—心血管疾病]