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 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 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.