摘要
目的研究急性冠脉综合征（ACS）患者血小板膜糖蛋白的表达意义及临床价值，并探讨替罗非班在ACS患者中的有效性和安全性。方法对60例冠脉造影异常患者（ACS组）、20例有不同程度的动脉粥样硬化危险因素，但冠脉造影正常患者（危险组）及25例健康体检者（对照组）进行血小板常规检测及血小板功能测定。其中ACS组根据用药的不同分为受试组（28例）和对照组（32例），进行治疗后血小板功能及心血管事件、出血不良反应发生率的比较。结果血小板计数、平均体积及分布宽度在各组间差异均无统计学意义（P〉0．05）。ACS组血小板膜糖蛋白水平较危险组和对照组明显偏高，差异有统计学意义（P〈0．05），但危险组与对照组比较差异无统计学意义（P〉0．05）。经二磷酸腺苷（ADP）诱导活化处理后ACS组血小板膜糖蛋白水平无明显变化（P〉0．05），而危险组及对照组均明显升高。差异有统计学意义（P〈0．05）。危险组血小板膜糖蛋白与对照组虽差异无统计学意义（P〉0．05）。但总体水平偏高。替罗非班治疗48h后受试组血小板膜糖蛋白表达率较对照组偏低，差异有统计学意义（P〈0．05）。结论ACS患者血小板膜糖蛋白水平较无ACS患者偏高，且持续活化表达能力较低，有动脉粥样硬化危险因素的患者血小板膜糖蛋白水平亦偏高，血小板膜糖蛋白的检测可作为判断ACS患者病情严重程度及指导临床早期干预的重要指标。早期替罗非班抗血小板治疗可改善长期预后。临床应用相对安全。
Objective To study the changes and clinical significance of Platelet membrane glycoproteins in patients with acute coronary syndrome （ ACS ） , and to explore the efficacy and safety for tirofiban in patients with ACS. Methods Based on both with or without atherogenic risk factors and Clinical symptoms and the result of coronary arteriography, 105 patients were calssified into three groups ： control group （ n=25 ） , risk group （ n=20 ） and ACS group （ n=60 ） . Platelet routine test and determination ofplatelet function were performed. According to different drugs the ACS patients are divided into study group （ 28 cases ） and control group （ 32 cases ） , then the platelet function and cardiovascular events and the bleeding adverse reaction were compared after treatment. Results From control group to risk group, then to ACS group, there was no signifcant difference between the groups in the platelet count, average volume and distribution width （ P〉0.05 ） .The level of membrane glycoproteins were higher in ACS group than the other two groups, there was both significant difference between the ACS group and the other two groups （ P〈0.05 ） . But there was no significant difference between the control group and the risk group （ P〉0.05 ） . After ADP-induced activation treatment, the level of membrane glycoproteins did not significantly changed in ACS group （ P〉0.05 ） , but elevated significantly in the control group and the risk group （ P〈0.05 ） .Risk group and control group in patients with various index is no statistical difference （ P〉0.05 ） , but the level of membrane glycoproteins in risk group were higher than the control group. After treatment oftirofiban for 48 hours, the expression rate of membrane glycoproteins in study group is lower than the control group, with statistical difference （ P〈0.05 ） . Conclusions Platelet membrane glycoproteins in patients with ACS are higher than those withoutACS, and sustained activation expression ability is low
出处
《浙江临床医学》
2016年第2期236-238,共3页
Zhejiang Clinical Medical Journal
关键词
急性冠脉综合征
血小板膜糖蛋白
替罗非班
Acute coronary syndrome Platelet membrane glycoproteins Tirofiban
