介入治疗对老年急性冠脉综合征患者血小板活化和炎症因子的影响

目的 探讨经皮冠状动脉介入治疗（PCI）对老年急性冠脉综合征(ACS)患者血小板活化和炎症因子的影响。方法68例经PCI治疗的老年ACS患者，在术前、术后次日、术后1周及术后4周清晨分别空腹抽肘静脉血测定P选择素（CD62P）、GPⅡb/Ⅲa受体复合物、血浆纤维蛋白原(fg)及血清高敏反应蛋白(hs-CRP)水平。并选择健康体检者44名作正常对照组。结果 CD62p、GPⅡb/Ⅲa、fg、hs-CRP水平ASC患者PCI术前、术后均较正常对照组增高（P<0.05），CD62p、GPⅡb/Ⅲa、fg、hs-CRP水平术前、术后在不同冠脉病变组间无统计学差异（P>0.05）。结论 老年ACS患者存在血小板活化和炎症反应，CD62p、GPⅡb/Ⅲa、fg、hs-CRP水平在术后4周内增高，术后4周内的抗血小板及抗凝治疗对防治PCI术后冠脉内血栓形成及再狭窄至关重要。

The Effect of Percutaneous Coronary Intervention Therapy on Platelet Activation and Inflammatory Factors in Elderly Patients of Acute Coronary Syndrome

Objective To explore the effect of percutaneous coronary intervention(PCI) therapy on platelet activation and inflammatory factors in elderly patients of acute coronary syndrome(ACS).Methods Sixty eight elderly ACS patients undergoing stenting were enrolled.Fasting venous blood of patients were collected to determine the expression of CD62p ,receptor complex of glucose protein Ⅱb/Ⅲa(GPⅡb/Ⅲa) ,plasma fibrinogen(fg) and serum high-sensitivity C-reactive protein(hs-CRP) befor PCI,on the next morning of PCI,on the morning after 1 week and 4 week of PCI respectively.The outcomes were compared with those determined in 44 healthy controls.Results The levels of CD62p、GPⅡb/Ⅲa、fg、hs-CRP in ACS patients were significantly higher than those in the healthy control（P<0.05），the levels of CD62p、GPⅡb/Ⅲa、fg、hs-CRP in three groups which were mild,moderate and severe,according to the Gensini score,did not yield a statistically significant differenct（P>0.05）.Conclusion PCI can ativate the platelet activation and inflammatory reaction,so it is critical to accent the antiplatelet and antithrombotic management especially during the 4 weeks after PCI to prevent stent thrombosis and restenosis.