摘要
目的观察急性冠脉综合征(ACS)患者血小板微粒(PMP)的变化对危险程度及对疾病预后的预测作用。方法收集ACS患者ST段抬高型心梗(STEAMI组)20例,非ST段抬高型心梗(NSTEAMI组)20例,不稳定心绞痛20例(UA组)临床资料进行回顾性分析,另选择同期健康体检者20例为对照组。采用流式细胞仪测定每组的血小板活化标志物CD62P、PAC-1和CD40L含量的变化。根据GRACE评分法将ACS组60例患者分为高危组(GRACE评分≥133分)34例、低中危组(GRACE评分<133分)26例,检测两组患者血小板微粒CD62P、PAC-1和CD40L的水平,并观察两组的住院期间的心律失常发生率,住院心衰发生率、28天的死亡率,并继续随访24个月的再次心梗、1年死亡率情况。分析血小板微粒值的高低与疾病预后的相关性。结果 ACS组患者CD62P、PAC-1和CD40L的水平与对照组比较差异有统计学意义(P<0.01);UA组、NSTEAIM组CD62P、PAC-1和CD40L的水平明显低于STEAIM组(P<0.05);UA组CD62P、PAC-1和CD40L的水平明显低于STEAIM组(P<0.05);低中危组患者CD62P、PAC-1和CD40L的水平明显低于高危组(P<0.05);低中危组患者心律失常发生率、住院心衰发生率、28 d死亡率明显低于高危组患者(P<0.05);继续随访24个月后低中危组患者再次心梗率、1年死亡率明显低于高危组患者(P<0.05)。结论 PMP的变化可以预测老年ACS患者危险程度及对疾病预后。
Objective To observe the predict effect of platelet microparticles(PMP) in elderly patients with acute coronary syn- drome(ACS) on risk degree and prognosis of the disease.Methods 20 cases of elderly ACS patients with ST segment elevation myocardial infarction(STEAMI group),20 patients with non ST segment elevation myocardial infarction(NSTEAMI group),20 cases of unstable angi- na(UA group) were retrospectively analyzed,at the same period 20 cases of healthy persons were selected as control group.Changes of acti- vation markers CD62P,PAC-1 and CD40L contents were determined with each flow cytometry platelet.According to GRACE score method,60 ACS patients were divided into high risk(GRACE ≥ 140,34 cases),the low risk(GRACE score<140,26 cases) groups.Patients in two groups were detected the level of CD62P,PAC-1 and CD40L platelet microparticles(PMP),and observed the incidence of cardiac ar- rhythmia during hospitalization,heart failure incidence,hospitalization,28 day mortality,and mortality follow-up of twenty-four months to 1 years again,re-myocardial infarction.Correlation between severity,prognosis analysis level of PMP value and the severity of coronary artery disease.Results There were significant differences in CD62P,PAC-1 and CD40L between ACS patients and the control group(P<0.01); CD62P,PAC-1 and CD40L levels in UA,and NSTEAIM groups were significantly lower than those of STEAIM group(P<0.05); CD62P,PAC-1 and CD40L in UA group were significantly lower than those of STEAIM group(P<0.05); CD62P,PAC-1 and CD40L lev- els in high risk group were significantly lower than those of low risk group(P<0.05); Rate of cardiac arrhythmia and hospital heart failure,28 day mortality in low risk group were significantly lower than those of high risk group(P<0.05).Follow-up twenty-four months,rates of re-myocardial infarction,1 year mortality in low risk group were significantly lower than those of high risk group(P<0.05).Conclusions PMP changes in elderly patients with ACS can predict the risk degree and the prognosis of the disease.
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2014年第1期58-60,共3页
Chinese Journal of Gerontology
基金
上海市松江区科学技术攻关项目区科委课题(No.2011SJGG27)
关键词
血小板微粒
急性冠脉综合征
血小板活化
Platelet microparticles
Acute coronary syndrome
Platelet activation
