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目的:观察冠心病(CHD)患者阿司匹林治疗前后血小板膜糖蛋白CD62p和GPⅡb/Ⅲa的变化,探讨其与阿司匹林抵抗(AR)的关系。方法:采用流式细胞术检测60例CHD患者(CHD组)及20例健康人(对照组)的血小板CD62p、GPⅡb/Ⅲa表达的阳性率。根据血小板聚集率(PAG)将CHD组分为AR亚组和阿司匹林敏感亚组(AS亚组)。60例CHD患者接受阿司匹林(100mg,qd)等治疗,2周后复检CD62p、GPⅡb/Ⅲa,并采用比浊法分别测定由二磷酸腺苷(ADP)、花生四烯酸(AA)诱导的PAG。结果:CHD患者治疗后血小板CD62p、GPⅡb/Ⅲa表达阳性率均比治疗前明显降低(P<0.01),但仍高于对照组(P<0.01)。入选60例CHD患者中有8例(13.3%)存在AR。AR亚组血小板GPⅡb/Ⅲa表达阳性率高于AS亚组(P<0.01)。结论:GPⅡb/Ⅲa可作为CHD患者阿司匹林治疗中早期识别AR的指标之一。
Objective: To observe the changes of platelet membrane glycoprotein CD62p and GPⅡb / Ⅲa in patients with coronary heart disease (CHD) before and after aspirin treatment and to explore its relationship with aspirin resistance (AR). Methods: The positive rates of CD62p and GPⅡb / Ⅲa expression in 60 CHD patients (CHD group) and 20 healthy people (control group) were detected by flow cytometry. The CHD group was divided into AR subgroup and aspirin sensitive subgroup (AS subgroup) according to platelet aggregation rate (PAG). Sixty patients with CHD were treated with aspirin (100 mg, qd). Two weeks later, CD62p and GPⅡb / Ⅲa were re-examined. PAG induced by adenosine diphosphate (ADP) and arachidonic acid (AA) were measured by turbidimetry. Results: The positive rates of CD62p and GPⅡb / Ⅲa in CHD patients were significantly lower than those before treatment (P <0.01), but still higher than those in control group (P <0.01). Eighty patients (13.3%) in the 60 selected CHDs had AR. The positive rate of platelet GPⅡb / Ⅲa expression in AR subgroup was higher than that in AS subgroup (P <0.01). Conclusion: GP Ⅱ b / Ⅲ a can be used as one of the indicators of early and middle stage AR in CHD patients treated with aspirin.