摘要
目的观察急性冠状动脉综合征患者在常规治疗及常规治疗+冠状动脉支架术治疗后的血浆血小板激活因子水平含量的变化,了解冠状动脉支架术对血浆内血小板激活因子(PAF)的干预作用,探讨拮抗PAF的临床对策。方法观察急性冠状动脉综合征(ACS)冠状动脉支架术组(26例)于支架术前、术后24 h及术后1周血浆PAF含量的动态变化,并与经临床常规治疗未置入支架的同类患者的血浆PAF水平进行对比。测定正常对照组(32例),男20例,女12例,年龄(60.2±6.8)岁及稳定型心绞痛组(SA)组(31例)男19例,女12例,年龄(62.3±5.9)岁,血浆PAF水平的含量,并与ACS未置入支架的患者血浆PAF水平对比。结果①ACS患者血浆PAF含量平均为(289±66)μg/L,明显高于正常对照组(P<0.05)及SA组(P<0.05);②冠状动脉支架术后24 h血浆PAF含量平均为(372±96)μg/L,明显高于其他各组(P<0.05);③支架术后1周PAF含量下降为(210±41)μg/L,明显低于常规治疗组(P<0.05),但仍高于正常人群水平。结论冠状动脉支架术有可能因内皮损伤与手术激惹,激活白细胞与血管内皮细胞过度分泌PAF而导致的高凝状态与“过度炎性反应”情况的存在。对准备接受冠状动脉支架术的患者,术前应充分做好拮抗PAF的准备,可减少手术激惹及组织损伤,从而减少导致PAF增加的因素。
Objective To investigate the changes in serum platelet activating factor（PAF） levels in patients with acute coronary syndrome （ACS） undergoing conventional treatment alone and conventional treatment plus stenting, and their differences between the ACS patients , stable angina（SA） patients, and controls, thereby exploring intervention effect of coronary artery stenfing on the serum PAF level.Methods ①The PAF levels in 26 ACS patients before stenting , 24 hours and 1 week after stenting were observed and compared with those in the ACS patients without stenting . ②The PAF levels in the control group （20 males, 12 females） ,SA group（19 males, 12 females） and ACS patients without stenfing were compared.Results ①The serum PAF level in the ACS patients before stenfing （289±66） μg/L significantly increased, compared with controls（ P 〈 0.05） and SA patients（ P 〈 0.05）. ②The senrm PAF level in the ACS patients 24 hours after stenting （372 ± 96） p.g/L was significantly higher than those in other groups（ P 〈0.05）.③The serum PAF level in the ACS patients 1 week after stenfing （210±41） μg/L was significantly lower than that in ACS patients without stenting. Conclusions Probably because of endothelium damage and irritation in the operation , the stent in the coronary artery makes the leucocytes and vascular endothelio cytes secret PAF excessively , resulting in hypercoagulabale state and excess inflammatory reaction. For the patients undergoing stenting , in order to reduce the increased secretion of PAF , preparation for resisting PAF should he done before the operation and the operative irritation and tissue damage should he minimized during the operation.
出处
《武警医学》
CAS
2006年第5期332-335,共4页
Medical Journal of the Chinese People's Armed Police Force
基金
武警医学院基金项目(WY2003-13)
