经皮冠状动脉腔内支架植入术后血小板L-精氨酸/一氧化氮途径的变化

通过观察冠心病人PTCA支架植入术后血小板一氧化氮（NO）生成、NO合酶（NOS）活性和L-精氨酸（L－Arg）转运的变化，探讨PTCA支架术后血小板功能受损的机制。方法：正常对照组14例，其中男8例，女6例，平均年龄52．6±5．5岁；冠心病组11例，其中男9例，女2例，平均年龄53．3±4．8岁。对照组、冠心病组术前及术后不同时期分别取血测定血小板NO生成、NOS活性及L－Arg转运。结果显示：冠心病患者术前血小板NO生成、NOS活性及L－Arg转运明显低于正常对照组，且于术后即刻进一步下降（P＜0．01）；之后有所恢复，但至术后第6天仍未恢复正常（P＜0．05）。意义：PTCA支架术可能通过降低血小板NO合酶活性和L－Arg转运使血小板NO生成减少，此可能是术后血小板粘附聚集的原因之一。

Change of the L-Arginine/Nitric Oxide Pathway of Platelet after Coronary Artery Stent Implantation

To study the mechanism of the dysfunction of platelet after coronary artery stent implantation (CASI),we observed the change of the product of nitric oxide (NO),activity of NO synthase (NOS) and L-Arginine transport before and after CASI. The study included two groups:Ga (14 normal co-ntrols) and Gb (11 patients with coronary artery disease). The result showed that the product of NO,NOS activity and L-Arg transport of platelet in Gb were lower than in Ga (P<0.01),and further decreased aft-er stent implantation compared with the level before the procedure (P<0.01). After that,the NO product,the activity of NOS and L-Arg transport recovered gradually,but still remained abnormal on the sixth day after the procedure (P<0.05).We inferred that CASI maybe decreased the NO product of platelet by i-nfluencing the NOS activity and L-Arg transport. This may be one of the mechanisms of adhesion and aggregation of platelet after coronary artery stent implantation.