实用医学杂志 ›› 2022, Vol. 38 ›› Issue (8): 934-937.doi: 10.3969/j.issn.1006⁃5725.2022.08.004

• 专题报道 • 上一篇    下一篇

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

刘军 贾志 霍立巍   

  1. 天津市北辰医院心内科(天津 300400)

  • 出版日期:2022-04-25 发布日期:2022-04-25
  • 基金资助:
    天津市北辰区科技发展计划项目(编号:2018⁃SHGY⁃15)

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

LIU Jun,JIA Zhi,HUO Liwei.   

  1. Internal Medicine⁃Cardiovascular Department,Tianjin Beichen Hospital,Tianjin 300400,China

  • Online:2022-04-25 Published:2022-04-25

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 NSTE⁃ MI 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 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。

关键词:

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

Abstract:

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 anti⁃ body,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.

Key words:

non ST segment elevation acute myocardial infarction, high residual platelet reactivity, Ⅱb/Ⅲa receptor, P?selectin, ischemic events