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通过采用流式细胞仪、酶联免疫吸附双抗体夹心法(ELISA)法、放射免疫法、全自动血凝分析仪等,检测冠心病患者血小板膜表面P-选择素(CD62p)、血浆组织型纤溶酶原激活剂(t-PA)及其抑制剂(PAI-1)、血清内皮素(ET-1),以及凝血4项即血浆纤维蛋白原(FIB)水平、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT),研究冠心病患者血栓前状态相关指标改变并探讨其意义。结果表明,冠心病患者血小板膜表面CD62p的表达、血浆PAI-1、FIB3项指标均较正常组显著增高(P<0.05),而t-PA水平较正常组显著降低(P<0.05);冠心病患者APTT时间显著缩短(P<0.05)。由此可知,冠心病患者血小板活化、凝血功能增强、纤溶功能减退,存在明显的血栓前状态;测定血小板表面CD62p的表达、血浆t-PA和PAI-1及凝血4项有助于早期发现冠心病患者血栓前状态并以指导临床早期干预治疗。
The levels of P-selectin (CD62p), plasma tissue type and cell cycle in platelets of patients with coronary heart disease were detected by flow cytometry, enzyme-linked immunosorbent assay (ELISA), radioimmunoassay and automatic hemagglutination analyzer. (T-PA) and its inhibitor (PAI-1), serum endothelin (ET-1), and coagulation 4, ie, fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) in patients with coronary heart disease were studied. The results showed that CD62p, PAI-1 and FIB3 in plasma of patients with coronary heart disease were significantly higher than those in normal group (P <0.05), while the levels of t-PA were significantly lower than those in normal group (P <0.05) APTT patients with heart disease significantly shorter (P <0.05). Thus, coronary heart disease patients with platelet activation, coagulation enhancement, fibrinolysis decreased, there is a significant prethrombotic state; determination of platelet surface CD62p expression, plasma t-PA and PAI-1 and coagulation contribute to early detection Prethrombotic state of patients with coronary heart disease and to guide clinical early intervention.