抑郁症对STEMI患者经皮冠状动脉介入治疗（PCI）前后血小板活化影响研究

目的：探讨抑郁症对急性ST段抬高型心肌梗死（STEM I）经皮冠状动脉介入治疗（PCI）前后血小板活化影响。方法：209例行PCI的患者分为抑郁症组（72例,包括持续性抑郁患者31例和一过性抑郁患者41例）和非抑郁症组（137例）。对照组35例为冠状动脉造影正常患者。分别于术前1天内和术后3个月通过BECK抑郁自评问卷（BD I）进行心理测评。取外周血,以β-血小板球蛋白（β-TG）作为血小板活化标志物,ELISA法测定浓度。结果：PCI组术前β-血小板球蛋白（β-TG）浓度水平较对照组明显升高,术后下降,持续抑郁症组β-TG浓度较非抑郁症组升高。对照组β-血小板球蛋白（β-TG）浓度在冠状动脉造影前后无显著性变化。结论：血小板活性在PCI前后有动态改变,在合并持续抑郁症患者中,血小板的活化程度较高。

The Clinical Study the Inflwence of Depression on Platelet Activation in STEMI Patients Treated with Primary PCI

Objective： To evaluate the inflwence of depression on the state of PLT activation in patients with STEMI treated with primary PCI. The assessment of PLT activation was based on the concentration of β - TG as serum markers of the activation. Method： The study group consisted of 209 patients with STEMI treated with primary PCI which was divided into two groups： Group A - 137 persistently nondepressed patients,and group B- 72 patients with depression,including 31 persistently depressed patients and 41 remittent depressed patients. The control group consisted of 35 healthy subjects an immunoenzymatic method （ ELISA, stago diagnostic ） was used to measure the β - thromboglobulin blood plasma concentration. β - TG was measured at baseline and 3 months after PCI. Result： Post -procedural levels of β -TG showed a decrease compared with preprocedural levels . Preprocedural peak levels of β - TG were higher in patients with depression than those in patients without depression. Conclusion： Intravascular platelet activation showed a dynamic change before and after PCI. Patients with STEMI suffering from depression show enhanced intravascular platelet activation.