心绞痛患者介入术后血小板活化及纤溶功能的变化

目的 研究冠心病不稳定心绞痛患者经皮冠状动脉腔内成形术（PTCA）和冠状动脉内支架术（stent)后外周循环中血小板活化及纤溶功能的变化。方法 由外周静脉采血，采用ELISA检测PTCA和stent术前后血浆血小板表面α-颗粒膜蛋白（GMP-140），血管性假血友病因子（VWF），组织纤溶酶原激活剂（t-PA)，纤溶酶原激活剂抑制物-1（PAI-1），D-二聚体（D-D）的含量。结果 31例不稳定型心绞痛患者PTCA术后10min血浆血小板膜表面GMP-140及D-二聚体明显增高。术后24h虽明显下降，但血小板膜表面GMP-140尚未降至正常，PAI-1术后24h亦明显增高。结论 冠心病不稳定型迟缓绞痛患者PTCA和stent术后确有血小板活化和纤溶活性受损。

Changes of platelet activation and the systemic fibrinolysis after interventional treatment in the patients with unstable angina

Objective To investigate the changes of the platelet activation and the systemic fibrinolysis after PTCA and (or) coronary stent implantation in patients with unstable angina(UA).Methods The plasma concentration of platelet alpha-granule membrane protein(GMP-140),plasminogen activator inhibitor-1(PAI-1),tissue plasminogen activator(t-PA),Von Willebrand factor (VWF)and D-dimer(D-D) of the blood samples which were drawn from vein according to the schedule and were measured by ELISA.Results In the thirty-one patients with UA,at 10 minutes after the operation,plasma level of GMP-140 and D-dimer were significantly higher than those before,and decreased gradually.But plasma level of GMP-140 couldn't reach normal level at 24 hours after operation.Plasma level of PAI-1 also significantly increased at 24 hours after operation. t-PA and VWF had no significant changes.Conclusion It indicated that the platelet activation and impaired fibrinolytic activity were occurred in the patients with UA after PTCA and (or) stent.