摘要
目的:观察急性非ST段抬高心肌梗死患者血浆可溶性P(sP)选择素的动态变化及早期抗栓治疗对它的影响。方法:急性非ST段抬高心肌梗死发作6 h内入院患者18例,ELISA法测定心肌梗死发作6、12、24、48、72 h的sP选择素,并同时测定血常规和C反应蛋白浓度。所有患者在入院时进行阿司匹林加噻氯吡啶联用低分子肝素抗栓治疗,另选稳定性心绞痛患者21例及非冠心病患者20例作为对照。结果:(1)急性非ST段抬高心肌梗死患者发病6 h内sP选择素的浓度显著高于稳定性心绞痛组和非冠心病患者组(167．4±18．1 ng／ml vs 75．4±6．8 ng／ml vs 67．9±7．7 ng／ml,P<0．001);症状发作12 h、24 h sP选择素浓度仍维持在高水平(180．2±16．6 ng／ml,160．4±14．5 ng／ml);发病48 h、72 h．sP选择素浓度与对照纽比较无统计学差异。(2)急性非ST段抬高心肌梗死患者发病6 h白细胞计数,中性粒细胞百分比与C反应蛋白即升高,24 h达高峰,72 h后仍高于正常。结论:急性非ST段抬高心肌梗死发生6 h P选择素水平明显升高,早期抗栓治疗使P选择素在24 h后下降,第48小时达基线水平,但不能完全抑制炎症反应。
Objective：To observe the dynamic changes of plasma soluble P-selectin in patients with non ST-segment elevation AMI and the effect of early antithrombotic therapy on soluble P-selectin. Methods：The plasma sP-selectin was measured at the time of 6, 12, 24, 48, 72 hours of AMI onset in 18 patients admitted within 6 hours of symptom onset. Blood routine test and C-reactive protein （CRP） were also measured at the same time. All patients were given antithrombotic therapy （aspirin and ticlopidine plus low molecular heparin） at the time of admission. And the concentration of those in 21 patients with stable angina pectoris and 20 normal controls with no coronary heart disease were measured also. Results： （1） The level of sP-selectin was higher significantly within 6 hours of symptom onset in AMI patients with non ST-segment elevation than those in patients with stable angina and the control （167.4 ± 18. 1ng/ml vs 75.4 ± 6.8ng/ml vs 67.9 ± 7.7ng/ml P〈0. 001 ）. The concentration of sP-selectin was still high at 12 and 24 hours of symptoms onset （180.2 ± 16. 6ng/ml, 160. 4 ± 14. 5ng/ml）. There was no difference between the level of sP-selectin at 48, and 72 hours of symptoms onset in AMI patients and that in the controls. （2） The white cell count and the level of CRP increased at 6 hours, climaxed at 24 hours, and were high at 72 hours after the symptoms onset in patients with no ST-segment elevation AMI. Conclusion：sP-selectin arose significantly after 6 hours of symptoms onset in AMI patients with non ST-segment elevation. The level of sP-selectin decreased after 24 hours and backed to baseline at 48 hours of symptoms onset by early antithrombotie therapy. But inflammation reaction was not inhibited completely.
出处
《中国临床医学》
北大核心
2007年第2期139-141,共3页
Chinese Journal of Clinical Medicine
