谭金习,董梅,任法新

• 1:青岛大学
• 2:青岛大学医学院附属烟台毓璜顶医院心内科

摘要(Abstract)：

<正>再灌注治疗包括药物溶栓和经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI),通过开通闭塞的冠状动脉,恢复血供和心肌灌注,从而挽救缺血心肌,缩小梗死面积,保护心功能,改善患者的临床预后。但研究发现,冠状动脉血管的再通并不意味着心肌组织的有效灌注,也不一定能够挽救缺血心肌组织。心肌无复流(no-reflow,NR)指闭塞的冠状动脉血管经PCI成功再通后,由于心肌微循环功能障碍,导致缺血心肌

关键词(KeyWords)： 血小板-白细胞聚集体;心肌无复流;血栓机制;炎症机制

Abstract:

Keywords:

基金项目(Foundation): 烟台市科技发展计划(2013WS221)

作者(Author): 谭金习,董梅,任法新

参考文献(References)：

• [1]Galasso G,Schiekofer S,D'Anna C,et al.No-reflow phenomenon:pathophysiology,diagnosis,prevention,and treatment.Areview of the current literature and future perspectives.Angiology,2014,65:180-189.
• [2]杨大浩,谭宁.血小板白细胞聚集体与冠心病的关系.岭南心血管杂志,2011,17:156-159.
• [3]Michelson AD,Barnard MR,Krueger LA,et al.Circulating monocyte-platelet aggregates are a more sensitive marker of in vivo platelet activation than platelet surface P-selectin:studies in baboons,human coronary intervention,and human acute myocardial infarction.Circulation,2001,104:1533-1537.
• [4]Schchinger V,Britten MB,Zeiher AM.Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease.Circulation,2000,101:1899-1906.
• [5]Halcox JP,Schenk WH,Zalos G,et al.Prognostic value of coronary vascular endothelial function.Circulation,2002,106:653-658.
• [6]张东凤,宋现涛,吕树铮,等.急性ST段抬高心肌梗死患者急诊经皮冠状动脉介入治疗无复流现象相关因素分析.中国介入心脏病学杂志,2013,21:305-309.
• [7]Schmid-Schonbein GW,Engler RL.Granulocytes as active participants in acutemyocardial ischemia and infarction.Am J Cardiovasc Pathol,1987,1:15-30.
• [8]周全,黄锋.心肌缺血再灌注后无复流发生的炎症机制.海南医学,2013,24:2559-2562.
• [9]王乐丰,张大鹏.急性心肌梗死急诊再灌注治疗后心肌组织无复流的防治.临床内科杂志,2007,24:11-13.
• [10]Cerletti C,Tamburrelli C,Izzi B,et al.Platelet-leukocyte interactions in thrombosis.Thromb Res,2012,129:263-266.
• [11]da Costa Martins PA,van Gils JM,Mol A,et,al.Platelet binding to monocytes increases the adhesive properties of monocytes by up-regulating the expression and functionality of beta1 and beta2integrins.J Leukoc Biol,2006,79:499-507.
• [12]Evangelista V,Pamuklar Z,Piccoli A,et al.Src family kinases mediate neutrophil adhesion to adherent platelets.Blood,2007,109:2461-2469.
• [13]Izzi B,Pampuch A,Costanzo S,et al.Determinants of platelet conjugate formation with polymorphonuclear leukocytes or monocytes in whole blood.Thromb Haemost,2007,98:1276-1284.
• [14]Graff J,Harder S,Wahl O,et al.Anti-inflammatory effects of clopidogrel intake in renal transplant patients:effects on plateletleukocyte interactions,platelet CD40 ligand expression,and proinflammatory biomarkers.Clin Pharmacol Ther,2005,78:468-476.
• [15]Braun OO,Johnell M,Varenhorst C,et al.Greater reduction of platelet activation markers and platelet-monocyte aggregates by prasugrel compared to clopidogrel in stable coronary artery disease.Thromb Haemost,2008,100:626-633.
• [16]Steiner S,Seidinger D,Huber K,et al.Effect of glycoproteinⅡb/Ⅲa antagonist abciximab on monocyte-platelet aggregates and tissue factor expression.Arterioscler Thromb Vasc Biol,2003,23:1697-1702.
• [17]Lukasik M,Dworacki G,Michalak S,et al.Aspirin treatment influences platelet-related inflammatory biomarkers in healthy individuals but not in acute stroke patients.Thromb Res,2011,128:e78-e80.
• [18]Maugeri N,Di Fabio G,Barbanti M,et al.Parnaparin,a lowmolecular-weight heparin,prevents P-selectin-dependent formation of platelet-leukocyte aggregates in human whole blood.Thromb Haemost,2007,97:965-973.
• [19]Htun P,Fateh-Moghadam S,Tomandl B,et al.Course of platelet activation and platelet-leukocyte interaction in cerebrovascular ischemia.Stroke,2006,37:2283-2287.
• [20]Brambilla M,Camera M,Colnago D,et al.Tissue factor in patients with acute coronary syndromes-Expression in platelets,leukocytes,and platelet-leukocyte aggregates.Arterioscler Thromb Vasc Biol,2008,28:947-953.
• [21]Maugeri N,Brambilla M,Camera M,et al.Human polymorphonuclear leukocytes produce and express functional tissue factor upon stimulation.J Thromb Haemost,2006,4:1323-1330.
• [22]Palabrica T,Lobb R,Furie BC,et al.Leukocyte accumulation promoting fibrin deposition is mediated in vivo by P-selectin on adherent platelets.Nature,1992,359:848-851.
• [23]陆弘逾,陈德,顾俊,等.急性冠脉综合征患者血小板和白细胞异常表达组织因子的研究.中国实验血液学杂志,2013,21:678-683.
• [24]侯倩,崔炜.心肌缺血再灌注无复流现象机制的研究进展.心血管病学进展,2013,34:631-636.
• [25]杨文波,黄广勇.中性粒细胞与心肌梗死心肌灌注关系的研究进展.心血管病学进展,2013,34:839-843.
• [26]Lievens D,Zernecke A,Seijkens T,et al.Platelet CD40L mediates thrombotic and inflammatory processes in atherosclerosis.Blood,2010,116:4317-4327.
• [27]Cerletti C,de Gaetano G,Lorenzet R.Platelet-leukocyte interactions:multiple links between inflammation,blood coagulation and vascular risk.Mediterr J Hematol Infect Dis,2010,2:e2010023.