【摘要】 观察急性心肌梗死（ＡＭＩ）和稳定型心绞痛（ＳＡＰ）血液中血小板表面糖蛋白ＧＰⅡｂ和ＧＰⅢａ的动态变化，探讨急性心肌缺血前、后血小板的活性。方法：６１例住院的冠心病患者，其中 ＡＭＩ ３２例，ＳＡＰ ２９例，采用竞争性酶联免疫方法比较ＡＭＩ及 ＳＡＰ患者发病后２４ ｈ，第２天、第３天、１周和２周时血中血小板ＧＰⅡｂ和ＧＰⅢａ的含量动态变化，并进行统计学分析。结果：ＳＡＰ组 ＧＰⅡｂ和 ＧＰⅢａ在上述 ５个时间段分别是 ６．８６± ２．７４／５．９４±１． ９６、６．２５ ±１　．８６／５．６１± １．４５、６．７４± ２．６７／６．０７± １．９９、５．９６± ２．３５／５．７６±１．５９、７．５６± ２．７２／７． １７± ２．４５（ｘ１０~４／Ｐｔ），均高于对照组（ＧＰⅡｂ、ＧＰⅢａ分别是３．９１±０、３６／４．５３±０．５１），经方差分析有显著性差异（Ｆ＝７．５４，Ｆ＝４．０３，均Ｐ＜０．０１）。相关分析与时间均无相关（ｒ＝０．５，ｒ＝０．４８，均 Ｐ＞０．０５），说明 ＳＡＰ有血小板的活化。 ＡＭＩ组 ＧＰⅡｂ和ＧＰⅢａ在上述时间［分别是 ８．３８ ± ２．３８／７．６２ ±１．６９、８．３９ ± ２．５５／７．６４±１．８６、８?更多还原

【Abstract】 To observe dynamic changes of platelet membrane glucoprotein(GP) Ⅱb and GPⅢa in blood circulation in acute myocardial infarction(AMI)and stable angina pectoris(SAP)of coronary heart disease, in order to investigate platelet activation before and after acute iechemic onset. Methods: Platelet membrane GPⅡb and GPⅢa were examined for 6lh os- pitalized cases with AMI or SAP at 24 hours, second day, third day,first week and second week after the attacks,using EIA and statistical analyses. Results:Platelet GPⅡb and GPⅢa contents of SAP group at 24 h, second day, third day, 1st,2nd week[6.86 ± 2.74/5 .94 ± 1 .96,6.25 ± 1 .85/5 .61 ± 1 .45,6.74 ± 2.67/6.07 ± 1 .99,5 .96 ± 2.35/5 .76 ± 1 .59,7.56 ± 2.72/7. 17 ± 2.45 (× 10~4 /Pt respectively)]were higher than those of control group[3 .91 ± 0.36/4 .53　±0.51 (× 10~4 / Pt) ],there was significant between-group difference, it showed that platelets were activated. GPⅡb and GPⅢa of AMI group at 24 h, second, third day, lst, 2nd week[8.38 2.38/7.62 ± 1 .69, 8.39 ± 2.55/7.64 ± 1 .86, 8.32 ± 2 .38/ 7.29 ± 1 .45,7.40 ± 2. 10/6.73 ± 1 .46, 6.53 ± 2. 18/6.36 ± 1 .29(x 10~4 /Pt)]were higher than the control group(P< 0. 01 ), there was significant between-group difference. GPⅡb and GPⅢa of AMI group had peak time at least within 3 days and a negative correlation with time. Comparison of GPⅡb and GPⅢa of AMI group with SAP group in first 3 days showed significant differences,but there were no significant differences between these tow groups at lst weed and 2nd week. Con- clusions:Platelets activation at AMI persisted 3 days peak time at least, it showed that GPⅡb and GPⅢa took part in the attack of AMI. So it is necessary to use the platelet GPⅡb and GPⅢa inhibitor in AMI, especially within first 3 days.更多还原