偏头痛病人血小板 聚集率测定

偏头痛是神经科常见病，据国内调查，偏头痛的年患病率为985．2／10万人口，发病率为79．7/10万人口。血小板在本病中的作用引起了人们注意。本文旨在观察偏头痛病人血小板活性和变化规律．从而对偏头痛的发作因素进一步防治提供了依据.     

经皮冠状动脉支架术前后血小板聚集率的变化及其临床意义

目的研究冠心病患者经皮冠状动脉支架术前后血小板聚集率的变化及临床意义.方法13例行冠状动脉造影的患者及20例行冠状动脉支架术的患者于术前、术后分别在冠状动脉、冠状窦口取血测定血小板聚集率.结果经皮冠状动脉支架术组血小板的聚集率在术后明显增加,冠状动脉造影组血小板的聚集性无明显改变.结论血小板的聚集率在经皮冠状动脉支架术后明显增加,应采取措施降低血小板聚集率.     

143例脑梗塞患者血小板聚集率和血液流变学分析

我们测定了143例脑梗塞患者(按1986年第二次全国脑血管病会议标准确诊)的血小板聚集率(PAgt)和血液流变学五项指标,并与对照组比较。结果见表1、表2。 讨论:由表1看出脑梗塞组血小板1分钟、5分钟和最大聚集率均高于正常对照组(P<0.01)。脑梗塞时,由于血管内皮细     

血小板膜糖蛋白和血小板聚集率变化与冠心病的临床意义

目的观测冠心病(CHD)患者血小板膜糖蛋白(GP)、血小板最大聚集率(PAgT)、血脂水平的变化及相关性。方法选择CHD患者122例,其中稳定性心绞痛(SAP)患者54例(SAP组),不稳定性心绞痛(UAP)患者68例(UAP组),另选健康体检者48例(对照组)。又根据有无冠状动脉事件分为心血管事件组(57例)和无心血管事件组(65例)。测定各组血GP、PAgT及血脂水平。结果 UAP组患者GP、PAgT水平明显高于对照组及SAP组患者。心血管事件组GP、PAgT也明显高于无心血管事件组;SAP组患者血小板表面α颗粒GP-140、PAgT水平明显高于对照者;回归分析发现,CHD患者PAgT水平与GP、LDL-C、脂蛋白(a)呈正相关。结论 PAgT水平升高是CHD患者冠状动脉事件发生的重要因素,高脂血症可以促进血小板在冠状动脉硬化过程中的活化。     

罗布麻茶对血小板聚集率及血液流变学的影响

本文报道5～8、9～12及13～16周疗程罗布麻茶对血小板聚集率及血流变的作用。13～16周组治后1′及5′血小板聚集率均显著降低(分别为43.04±14％→35.53±11％;59.99±17％→47.56±17％;均P<0.01)。13～16周组治后血球压积下阵,(41.8±5.3→39.4±4.6,P<0.01),全血粘度略下降。建议用罗布麻茶作为保健饮料时必须长期服用而不能求速效。     

银杏叶提取物对急性脑梗死患者血小板聚集率的影响

目的探讨银杏叶提取物(EGB)对急性脑梗死患者血小板聚集率的影响,并观察其临床疗效。方法将105例急性脑梗死患者随机分为两组。对照组接受常规治疗,试验组在常规治疗基础上加用EGB治疗,于用药前及用药后第14天分别测定两组患者血小板聚集率水平,并进行神经功能缺损评分。结果试验组血小板聚集率较对照组下降明显,神经功能缺损改善显著,差异有统计学意义(P<0.05)。结论急性脑梗死患者使用EGB后可使血小板聚集得到显著抑制,同时使患者神经功能得到明显改善。     

不同氯吡格雷代谢型急性心肌梗死患者的血小板聚集率变化

目的观察不同氯吡格雷代谢型急性心肌梗死患者使用氯吡格雷后血小板聚集功能的被抑制情况。方法入选2013年3—8月急性心肌梗死患者48例,经过基因检测分为氯吡格雷慢代谢型6例、快代谢型17例和中间代谢型25例。患者均于入病房前服用负荷剂量阿司匹林300 mg和氯吡格雷300 mg,之后阿司匹林100 mg/d和氯吡格雷75 mg/d连续服用,于服药后第6天检测血小板聚集率、血细胞计数、纤维蛋白原含量和肝肾功能。结果所有患者服用氯吡格雷后第6天的血小板聚集率明显下降,二磷酸腺苷、肾上腺素诱导的抑制率分别为74%和84%。氯吡格雷快代谢型、中间代谢型和慢代谢型3组急性心肌梗死患者的二磷酸腺苷诱导的血小板聚集率分别为22.2%±13.4%、32.1%±20.1%和18.6%±13.9%(P>0.05),3组血小板抑制率分别为87%、78%和82%。结论本研究中不同氯吡格雷代谢型急性心肌梗死患者的血小板聚集功能的抑制情况无明显差异。     

血小板聚集率对感染性心内膜炎不良预后的预测价值

感染性心内膜炎(infective endocarditis,IE)是一种严重的心血管疾病,其发生率在十万分之三至十万分之十之间,但病死率达到15%~30%。早期识别不良预后的IE患者可能是指导临床决策的重要方法,也是临床医师的关注重点。在IE的病理生理中,血小板具有重要作用,血小板聚集通常被认为是致病因素之一,也是IE赘生物生长的条件。根据IE病理生理的理论基础、抗血小板药物对IE患者的预后及血小板聚集率对相关疾病预后的相关研究,血小板聚集率可能对IE患者的不良预后有预测价值,但有待进一步研究。     

老年冠心病患者血小板聚集率与心血管不良事件的关系

目的 分析老年冠心病(CHD)患者血小板聚集率(PAG)情况及其与心血管不良事件(MACE)发生的关系.方法 回顾性分析60例老年CHD患者临床资料,所有患者接受阿司匹林口服治疗并完成随访;随访时间6个月,评估患者MACE发生情况并分组;设计基线资料填写表,仔细阅读患者相关资料并记录患者的基线资料情况,检测并比较PAG...     

健康人24小时QT变异度

目的　描述健康人的 2 4小时 QT变异度。方法　 5 8例健康人在日常生活状态下接受 2 4小时 Holter监测 ,计算机自动计算每小时 QT间期均数 (QTm )和标准差 ,后者用以表示相应时间段的 QT变异度 (QTv)。以频域法同步分析心率变异性。结果　夜间迷走神经活性增高时 QTm值大 (最大值为 371±2 1m s,于 0 3:0 0 - 0 4:0 0时间段 )、QTv值小 (最小值为 5 .8± 0 .7m s,于 0 1:0 0 - 0 2 :0 0时间段 ) ,白天交感神经活性增高时 QTm值小 (最小值为 30 5± 12 m s,于 11:0 0 - 12 :0 0时间段 )、QTv值大 ,主要以上午最大并于 0 7:0 0 - 0 8:0 0达 2 4小时最高值 (15 .9± 2 .6 ms)。结论　健康人的 2 4小时 QT变异度与自主神经活性状态有关 ,呈昼夜节律性变化。     

健康人心室复极的昼夜变化研究

目的 探讨健康人心室复极的昼夜变化规律. 方法 对34例健康体检者的24h动态心电图进行回顾性分析.测定其心率、Q-T间期、QRS波群起点至T波波峰的时间(Q-Tp间期).计算T波波峰至终点的时间(Tp-e时间)、心率校正的Q-T间期(Q-Tc间期)和Tp-e时间(Tp-ec时间)、Tp-e/Q-T值,并比较一天中8个等分时间段的上述参数. 结果 Q-T间期和Tp-e时间呈日间短、凌晨及午夜长的昼夜节律变化,各时间段差异有统计学意义(P<0.01或0.05);Q-T间期与心率呈高度负相关(r=-01796，P<0.01)．而Tp-e时间与心率呈低度负相关(r=-01267，P<0.01)；各时间段Q-Tc间期接近,而Tp-ec时间呈07:00～09:00最高、10:00～12:00次之、01:00～03:00最低的昼夜节律变化,各时间段差异有统计学意义(P<0.05),Tp-e／Q-T值昼夜变化节律与Tp-ec时间相近.结论 反映心室复极跨壁离散度的Tp-e时间除受心率影响外,尚受昼夜节律的影响.     

A Study of the Normal Pattern of Platelet Aggregation in Healthy Saudis: A Population-based Study

Platelet aggregation in response to ADP, adrenaline, collagen, arachidonic acid and ristocetin was measured in a large population of healthy Saudi males (n = 393) and females (n = 221) whose age ranged from 11-60 years. The number of observations ranged from 130 for one of the doses of ristocetin (1.0 g/l) to 554 for one of the doses of ADP (2.0 mol/l). Females exhibited more enhanced aggregation responses than males. Blood groups, smoking and body weight had no significant effect on platelet aggregability. No significant variations were noted when morning versus afternoon measurement were compared. The results are discussed and compared to previous reports based on small population studies. The data obtained represent the normal pattern of platelet aggregation in healthy Saudis.     

The Peripheral Platelet Count and ADP-Induced Platelet Aggregation in Response to Metoprolol and Propranolol as Studied in Young Healthy Male Volunteers

In previous studies, we have demonstrated that the oral administration of one single dose of metoprolol as well as of propranolol causes a significant increase in the venous platelet concentration. In the present study, we investigated the effect of metoprolol, administered twice daily over a period of 1 week, on the venous platelet count in a group of healthy volunteers. The results showed that the drug significantly raised the venous platelet concentration over the whole study period. Further, the effect of 1 week's metoprolol and propranolol medication on ADP-induced platelet aggregation was investigated in another group of healthy subjects; the results were compared to those obtained during 1 week of placebo medication. It was demonstrated that neither of the two β-blocking drugs affected ADP-induced platelet aggregability; this was true on the first as well as on the last day of study.     

Late Potentials in Healthy Subjects

Objective: Criteria for detection of late potentials have not yet been standardized, but the criteria recommended by ESC/AHA/ACC are widely used. In this investigation, the prevalence of late potentials is studied in an age stratified healthy population with likelihood of coronary artery disease < 5%. Relation between signal-averaged variables and clinical variables was studied. Methods: Signal-averaged ECGs were recorded using Butterworth filters at 40 and 250 Hz. The following three time-domain parameters were evaluated: QRS duration (duration of the amplified, filtered QRS complex); LPD (duration of the late potentials, i.e., duration from the point of time when the magnitude of the main complex becomes lower than 40 μV); and RMS40 (root mean square of the activity within the last 40 ms of the amplified, filtered QRS complex). Results: QRS duration was significantly longer in men than in women, and was correlated to the mass of the left ventricle (LVM). The combination LPD and RMS40 gave the highest prevalence of late potentials. The prevalence of late potentials was 25%. Conclusion: Standard criteria should be used with great caution, and normal limits should be established in each laboratory to a preselected noise level. QRSD should be included within the definition of reference limits and should be gender matched. Even though there is correlation between LVM and the QRSD, the upper normal limit of QRSD based on LVM matching is unchanged.     

Quantitative Study of Circadian Variations of Ambulatory Blood Pressure in Chinese Healthy,Hypertensive, and Diabetes Subjects

Ambulatory blood pressure monitoring (ABPM) recorded abundant data of BP and heart rate (HR) variations with even more derived parameters for evaluation of BP. Using our ABP database system established recently, we studied quantitatively the data of 24-hr ABP in Chinese. First, 155 Chinese were divided into three groups: 50 healthy subjects (C) of 20 men and 30 women, aged 60.0 ± 10.3 (SD) years; 58 hypertensive patients (H, mild or moderate hypertension) of 33 men and 25 women, aged 59.4 ± 8.0 years; 47 diabetes patients (D, type 2 diabetes, all were normotensive and with no insulin treatment) with 28 men and 19 women, aged 61.0 ± 8.5 years. Then 24-hr ABP was monitored by TM-2421 Monitor and data were analyzed by ABP database, cosinor method, and conventional statistics. Our results were 4-fold: 1) systolic BP (SBP), diastolic BP (DBP), HR, rate-pressure product (HR × SBP) showed circadian variations, and significant circadian rhythms were confirmed by cosinor method in all groups. MESOR (midline estimate statistic of rhythm) differed significantly among three groups (H had the highest and C had the lowest values); 2) BP means (SBP, DBP, pulse pressure [PP], and HR × SBP) and BP loads (SBP, DBP, and PP) showed significant differences among the groups (H and D had higher values than that of C); 3) there were no significant differences of BP variability (BPV) of SBP, DBP, and PP among the groups; 4) areas under curve of BP (SBP, DBP, and PP) in H were significantly higher than in C and there was no significant difference between H and D. We concluded that ABPM can offer abundant information on BP evaluation by its direct recording data and derived parameters. The computerized way of treating the large numbers of ABPM values supplies a useful tool in evaluation of BP. Our results suggest that clinically normotensive diabetes patients had some pathological alterations in their BP systems.     

Platelet Aggregation in Neonates with Hyperbilirubinaemia

In 19 jaundiced newborns who had no evidence of kernicterus the effect of bilirubin on adenosine-5′-diphosphate (ADP), epinephrine and collagen-induced platelet aggregation was studied. Compared to 20 normal adult controls, no significant difference was found for ADP and collagen-induced platelet aggregation in jaundiced infants. However, with epinephrine, significantly decreased aggregation was observed, but this was also the case for non-jaundiced infants. This suggests that the reduced response to epinephrine in hyperbilirubinaemic infants is related to age rather than to bilirubin. Increased bilirubin is therefore not responsible for any increased bleeding tendency due to impaired platelet function.     

Racial Differences in Ristocetin-induced Platelet Aggregation

S ummary . Several investigators have reported defective ristocetin-induced platelet aggregation (RIPA) in individuals whose red blood cells contain sickle haemoglobin, but the race of control subjects in these studies was not stated. Therefore, maximal amplitude of RIPA was examined in 75 normal whites and blacks, 16 of whom had sickle trait defined by haemoglobin electrophoresis and sickle prep. Final ristocetin concentrations in platelet rich plasma were 1·1,1·2 and 1·5 mg/ml. Mean aggregation at 1·1 mg/ml was significantly less in blacks (mean 31%) than in whites (mean 72%) ( P < 0·001). 60% of blacks but only 11% of whites had less than 50% RIPA at 1·1 mg/ml. RIPA was entirely absent in 19% of blacks. Differences in RIPA between black and white subjects were also present at ristocetin concentrations of 1·2 and 1·5 mg/ml but were less striking. RIPA in 25 children with homozygous sickle cell anaemia was similar to that in the normal AA and AS blacks. Differences in RIPA could not be explained by age, sex, presence of sickle haemoglobin, or medications. Addition of normal plasma or platelets did not correct reduced RIPA in seven blacks, and their plasma inhibited normal RIPA responses.
Reduced platelet aggregation to low concentrations of ristocetin is a normal finding in many blacks, is not related to the presence of sickle haemoglobin, and appears to be due to a plasma inhibitor against RIPA.