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目的:观察急性冠状动脉综合征(ACS)患者介入治疗前后血小板活化指标P选择素(CD62p)、糖蛋白(GP)Ⅱb/Ⅲa受体复合物、纤维蛋白原(FIB-C)和血管内炎症指标高敏C反应蛋白(hs-CRP)的变化及其临床意义。方法:100例ACS患者冠状动脉介入治疗(PCI)术前和术后次日凌晨分别空腹采肘静脉血用流式细胞仪检测定血清CD62p和GPⅡb/Ⅲa受体复合物的表达水平;用散射比浊法测定血浆FIB-C的水平;用乳胶免疫增强比浊法测定血清hs-CRP的水平。选择健康体检者40例和稳定型心绞痛患者50例作对照,观察ACS患者PCI前后指标的变化并与对照组比较。结果:ACS患者中,不稳定型心绞痛(UAP)组血清CD62p、GPⅡb/Ⅲa、FIB-C和hs-CRP的表达水平均明显高于健康对照组(均P<0.01)和稳定型心绞痛(SAP)组(分别P<0.05,P<0.01,P<0.05,P<0.01);急性心肌梗死(AMI)组明显高于UAP组(分别P<0.05,P<0.01,P<0.05,P<0.01)。冠状动脉病变程度不同上述指标也有所不同,急性闭塞组高于3支病变组(P<0.05),3支病变组高于双支病变组(均P<0.05),双支病变组较单支病变组也明显增高(分别P<0.05,P<0.05,P<0.05,P<0.01)。UAP和AMI组PCI术后CD62p、GPⅡb/Ⅲa、FIB-C和hs-CRP的水平较术前均有显著性增高(均P<0.01)。结论:血小板活化和炎症反应在ACS发生和发展过程中起了重要的作用,PCI术后血小板和炎症反应物质有一定程度的激活。
Objective: To observe the changes of platelet activation index P-selectin (CD62p), glycoprotein (GP Ⅱb / Ⅲa receptor complex, fibrinogen (FIB-C) and intravascular inflammation before and after interventional therapy in patients with acute coronary syndrome Changes and Its Clinical Significance of High Sensitive C - reactive Protein (hs - CRP). Methods: The expression of CD62p and GPⅡb / Ⅲa receptor in serum was measured by flow cytometry in 100 patients with coronary artery disease (PCI) before coronary intervention and in the early morning after surgery. Plasma FIB-C level was measured by turbidimetric method. Serum hs-CRP levels were measured by latex immunopotentiation. Select 40 healthy subjects and 50 patients with stable angina pectoris as a control, ACS patients before and after PCI changes in indicators and compared with the control group. Results: The serum levels of CD62p, GPⅡb / Ⅲa, FIB-C and hs-CRP in patients with ACS were significantly higher than those in healthy controls (all P <0.01) and patients with stable angina ) Group (P <0.05, P <0.01, P <0.05, P <0.01); AMI group was significantly higher than UAP group (P <0.05, P < ). The severity of coronary artery disease varied with the above indexes. The acute occlusion group was higher than the 3-vessel group (P <0.05), the 3-vessel group was higher than the double vessel group (all P <0.05) Lesion group was also significantly higher (P <0.05, P <0.05, P <0.05, P <0.01). The levels of CD62p, GPⅡb / Ⅲa, FIB-C and hs-CRP in UAP and AMI groups were significantly higher than those before PCI (all P <0.01). Conclusion: Platelet activation and inflammatory response plays an important role in the development and progression of ACS. Platelets and inflammatory response substances are activated to some extent after PCI.