【摘要】 目的探讨血小板膜糖蛋白(GP)Ⅱb HPA-3基因多态性与急性冠脉综合征(ACS)经皮冠状动脉介入治疗(PCI)前后血小板功能变化的关系。方法选择行PCI的ACS患者120例测定GPⅡb HPA-3基因型,测定各基因型PCI术前、术后即刻、术后24h三个时间段血浆GMP-140、vWF和PAI-1浓度。对不同基因型PCI前后血小板功能指标进行对比。结果经Logistic回归分析校正各因素后发现:GPⅡbHPA-3bb基因型是心肌梗死的独立危险因素。GMP-140在bb基因型组PCI术后即刻、术后24h较aa、ab基因型均增高(P<0.01)。vWF三种基因组差异无统计学意义。PAI-1bb在基因组PCI术后即刻比aa、ab基因型存在更明显的PAI-1活化(P<0.01)。结论血小板GPⅡb HPA-3bb基因型可能是心肌梗死的独立危险因素,并且该基因型ACS患者在PCI术后存在更迅速、更显著的血小板活化,提示bb基因型可能是PCI后血栓负荷过重和术后心血管事件的危险因素。更多还原

【Abstract】 Objective To investigate the possible relationship between platelet membrane glycoprotein(GP)IIb HPA-3gene polymorphism and changes of platelet function and the fibrinolytic activity in patients with acute coronary syndrome(ACS),undergoing percutaneous coronary intervention(PCI).Methods 120patients,who were definitely diagnosed with ACS in the Affiliated Hospital of Guiyang Medical College,were chosen to check platelet GP IIb HPA-3gene polymorphism by polymerase chain reaction-sequence specific primers(PCR-SSP).Before and after PCI immediately,and 24hours after PCI,the plasma GMP-140,vWF and PAI-1levels were determined to analysis the change of platelet function indicators in patients with different genotype.Results The Logistic regression analysis found that GPⅡbHPA-3bb genotype is a independent risk factor for acute myocardial infarction(AMI)after correction factors.The plasma GMP-140level in the bb genotype group was remarkably increased immediately and 24hours after PCI among the three genotypes(P<0.01).The plasma vWF level no statistical difference appeared among the three genotypes.The plasma PAI-1level immediately after PCI,there were statistical significantly differences between the bb genotype and the others(P<0.01).Conclusion The HPA-3polymorphism of GP IIb is the risk factor of AMI.There is remarkable platelet activation and the fibrinolytic activity changes in patients with GP HPA-3bb genotype than in those without it after PCI.The results are suggested that the bb genotype of platelet GP IIb HPA-3maybe a dangerous factor in acute and sub-acute coronary thrombosis after PCI.更多还原