血小板活化因子在急性冠脉综合征患者中的变化

目的测定急性冠脉综合征(acute coronary syndromes,ACS)患者血浆血小板活化因子 (platelet activating factor,PAF)和血栓烷B2(thromboxane B2,TXB2)水平,研究其含量变化在ACS发生、发展中的意义。方法分别采用反相高效液相色谱法(rHPLC)、放射免疫法(RIA)测定40例ACS患者(其中急性心肌梗死AMI 15例,不稳定型心绞痛UAP 25例)刚入院、入院24 h、入院72 h和40例健康对照组血浆PAF、TXB2值。结果 AMI组患者血浆PAF、TXB2均显著高于对照组,差异具有显著性(P<0．01), 并至少持续到72 h。PAF在入院后24 h最高,三个时间组相比差异有显著性(P<0．01)。TXB2三个时间组相比差异没有显著性(P>0．05)。UAP组刚入院、入院24 h、入院72 h的PAF和TXB2略高于对照组,但差异没有显著性(P>0．05)。AMI组PAF、TXB2值显著高于UAP组,差异有显著性(P<0．01)。结论 PAF、TXB2在ACS的发生、发展中发挥了重要作用。血浆PAF、TXB2水平的检测,对ACS诊断、疗效和预后判断具有指导意义。

The change of plasma platelet activating factor (PAF) and thromboxane B2 (TXB2) in patients with acute coronary syndrome (ACS)

Objective To determine the plasma levels of PAF and TXB2 of patients with ACS, and to study significance in the progress of ACS. Methods Patients were divided into two groups: acute myocardial infarction (AMI) group ( n = 15) and unstable angina pectoris (UAP) group ( n = 25) . PAF and TXB2 were measured on admission, at 24 hours and at 72 hours after admission in 40 patients with ACS and 40 control voluntecrs. Plasma PAF and TXB2 levels were measured by reversed phase high-performance liquid chromatographic technique (rHPLC) and radioimmunoassay (RIA). Results PAF and TXB2 levels were higher in patients with AMI than those in normal volunteers ( P < 0.01), the increased levels lasted at least 72 hours. Compared to admission, PAF at 24 hours and 72 hours were significantly increased ( P < 0.01) . There was no significant difference in TXB2 ( P > 0.05) . PAF and TXB2 levels were higher in patients with UAP than those in normal volunteers (P > 0.05) . PAF and TXB2 in AMI were higher than those in UAP (P < 0.01) . Conclusion PAF and TXB2 played important roles in occurrence and development of ACS. The measurement of PAF and TXB2 was useful in diagnosis, treatment. and predicting prognosis of ACS.