论文部分内容阅读
目的观察和分析急性ST抬高型心肌梗死(STEMI)患者服用氯吡格雷后4~6 h的残余血小板聚集率(RPA)和血浆中趋化因子CCL2表达之间的关系。方法入选STEMI患者107例。入院时均给予氯吡格雷600 mg,阿司匹林300 mg,在服用药物后4~6 h抽取静脉血,用光比浊法(TPA)检测ADP诱导的RPA,ELISA检测血浆中CCL2浓度。依据RPA检测结果分为2组:RPA≥59%为残余血小板高反应组(高反应组,n=51),RPA<59%为残余血小板正常反应组(正常反应组,n=56)。详细收集两组患者临床数据和血液生化检测资料。结果两组间在年龄、性别、吸烟史、高血压病、糖尿病、空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和脑钠尿肽(BNP)等方面均无明显的统计学差异。STEMI患者RPA与血浆CCL2浓度之间存在线性关系(r=0.427,P<0.01)。高反应组患者血浆CCL2浓度为(243±80)ng/L,正常反应组患者血浆CCL2浓度为(171±44)ng/L,两组间存在显著的统计学差异(P<0.01)。高反应组中肌钙蛋白T(TnT)、肌酸激酶同工酶(CK-MB)显著高于正常组[(3.1±2.3)U/L vs.(2.3±1.4)U/L;(198±16)μg/L vs.(151±13)μg/L,均P<0.05]。结论 STEMI患者残余血小板聚集率与趋化因子CCL2有相关性。
Objective To observe and analyze the relationship between remnant platelet aggregation rate (RPA) 4 ~ 6 h after clopidogrel and plasma chemokine CCL2 expression in patients with acute ST-elevation myocardial infarction (STEMI). Methods Selected STEMI patients in 107 cases. Admission were given to clopidogrel 600 mg, aspirin 300 mg, 4 to 6 h after taking the drug venous blood samples were detected by light turbidimetry (TPA) detection of ADP-induced RPA, ELISA detection of plasma CCL2 concentration. According to the results of RPA, the patients were divided into two groups: RPA≥59%, residual platelet response (n = 51), RPA <59%, residual platelet normal reaction (n = 56). Detailed collection of two groups of patients clinical data and blood biochemical test data. Results There were significant differences in age, sex, smoking history, hypertension, diabetes mellitus, fasting blood glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL- There was no significant difference in serum lipoprotein cholesterol (LDL-C) and brain natriuretic peptide (BNP). There was a linear relationship between RPA and plasma CCL2 concentration in STEMI patients (r = 0.427, P <0.01). The plasma CCL2 concentration was (243 ± 80) ng / L in patients with high response and in patients with normal response was (171 ± 44) ng / L. There was a significant difference between the two groups (P <0.01). The levels of TnT and CK-MB in the high-response group were significantly higher than those in the normal group [(3.1 ± 2.3) U / L vs. (2.3 ± 1.4) U / L; ± 16) μg / L vs. (151 ± 13) μg / L, all P <0.05]. Conclusion The residual platelet aggregation rate in STEMI patients is correlated with chemokine CCL2.