冠心病介入治疗后血小板、纤溶动态变化及其临床意义

通过对36例经皮腔内冠状动脉成形术（PTCA）成功的冠心病患者进行6个月随访，发现心绞痛复发组（B组，10例）血小板α颗粒膜蛋白-140水平手术后1、3、6个月时比无心绞痛复发组（A组，26例）高（分别P＜0．05、P＜0．01和P＜0．01）。血浆组织型纤溶酶原激活剂活性B组在术后呈下降趋势，其组织型纤溶酶原激活剂抑制剂活性则明显升高。血浆vWF抗原两组在术后1h均显著上升，以后A纷呈下降趋势，而B组仍保持较高水平。提示：PTCA术后临床症状复发、再狭窄发生与血小板持续高活性有关，同时内皮损伤、纤溶活性降低也起一定作用。

Changes of platelet activity and fibrinolytic activity in patients undergoing PTCA

After successful procedures of percutaneous transluminal corohary angioplasty (PTCA),36 patients were followed up with clinic status and angiography in 6 months. 26 of these patients without recurrence of angina were defined group A, 10 patients with recurrence of angina were group B and 6 of them received re-PTCA because of angiographic restenosis. All patients were deterndnated of platelet Q-granule membrane protein (GMP-140). plasma t-PA: a, PAI : A and vWF: Ag level. The results showed that the level of platelet GMP-140 were much higher in group B than those in group A at 1,3,6 months after PTCA. The levels of plasma PAI:a in group B at 3 months,6 months after PTCA were higher than those in group A. The levels of vWF: Ag at 1 h after PTCA were higher than those before rrCA in two groups. And then in group A the levels were dereased,in group B they still higher than those in group A. In conclusion,the high activity of platelet may play an important role in recurrence of angina and restenosis after successful PTCA.