冠状动脉介入术对血小板活性的影响及与支架血栓的关系Effect of Sirolimus-eluting stents implantation on platelet activation under dual anti-platelet therapy
薛朝阳,陈媛,陆民
摘要(Abstract)：
目的观察双联抗血小板基础上PCI前后动脉系统血小板活性的变化及与支架血栓的关系。方法20例行支架置入术的稳定性冠心病患者为PCI组,另20例单纯行冠状动脉造影术(CAG)者为对照组。测定术前及术后不同时间段外周动脉全血血小板纤维蛋白原受体ⅡbⅢa(plate-let fibrinogen receptor expression,PAC-1)、P选择素(P-selectin,CD62P)及动脉血浆各时间点内皮素(endothlin,ET-1)血栓素B2(thromboxane B2,TXB2)、纤维蛋白原(fibrinogen,FIB),并观察围术期及随访期严重心血管不良事件(main adverse cardiac events,MACE)发生率。结果在PCI组,术后6h与术前比较,PAC-1(2.626%±1.597%比1.388%±0.764%,P=0.001)、CD62P(0.363%±0.204%比0.213%±0.176%,P=0.007)、PAC-1+CD62P(0.261%±0.181%比0.133%±0.121%,P=0.003)差异有统计学意义。TXB2在PCI术后24小时与术前比较差异有统计学意义(474.84±190.43ng/mL比310.37±184.21ng/mL,P=0.021)。ET-1、FIB手术前后无明显变化。在CAG组,上述各指标CAG术前后无明显变化。两组均无MACE发生。结论对已采取标准双联抗血小板患者,PCI术仍可引起全身血小板激活,但对凝血功能及内皮功能无明显影响。
关键词(KeyWords)： 血管成形术,经腔,经皮冠状动脉;支架;血小板活化;内皮缩血管肽类
基金项目(Foundation): 宁夏回族自治区自然科学基金项目(NZD7112)
作者(Author): 薛朝阳,陈媛,陆民
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