The Effect Of PTCA On The Finction Of Plasma P-selectin And Plaminogen Activator Inhibitor-1 Of The Patients With Acute Conorary Syndrome

Acute coronary syndrome is 30% of coronary heart disease (CHD) , with a clinical manifestation of unstable angina pectoris, a-cute myocardial infarction or sudden cardiogenic death. It has been i-dentified that the coronary arteries are partly or absolutely occluded from the breakage and hemorrhage of the plaque of the coronary wall and then thrombosis. PTCA is one of the main methods to the coronary occlusion with a availability of 80 90% although with some compli-cations of myocardial recurrent injury, acute coronary occlusion and coronary restenosis. Some reports demonstrated the coronary restenosis rate after PTCA of 30 50% and acute coronary occlusion rate of 1 8% , which limited the long - term effect of PTCA Those complications are considered related with platelet activation, endothelial insuffiency and fibrinolysis system abnormal. P ?selection( PS) and plasminogen activator inhibitor type -1 ( PAI - 1) have a reflection of the function of the platelet and endothelial cell and the fibrinolytic activity. We in-vestigate PS and PAI - 1 to determine the effective factors of PTCA then to prevent the complications.MaterialMain reagents and equipments: PS and PAI - 1 ELISA origins Shanghai Sun Company. The main equipments include Midars 24 -lead EGG, HICOR T. 0. PI500mA(Siemens) , SANYO low -temper-ature refrigerator and HITACHI CF 7D2 centrifugator.Methods1. Patient selectionCirculation in the First Affiliated Hospital of China Medical Uni-versity from Jan. 2002 to Dec. 2002 are enrolled in this study. 45 pa-tients selected by random principle are divided into PTC A group (31 patients) and CAG positive control group(14 patients) ,with a history of unstable angina pectoris or acute myocardial infarction for 2 weeks and correspond the diagnostic standard established by WHO in 1979. 18 patients are selected randomly to form the CAG negative control group. Additionally, all the patients are not of history of acute myo-cardial infarction, severe renal failure, severe hepatic disease, tumor, rheumatoid or immune diseases.2. Sample collectionBlood of 3. 6 ml for the measurement of fibrinolytic parameters was drawn from an antecubital vein before PTCA, 10 minutes, 2 hours and 24 hours after PTCA. The blood was anticoagulated with 0.4 ml of 3.8% trisodium citrate(9:1) in precooled plastic tubes and platelet - poor plasma was obtained after centrifugation for 20 minutes with 3000r/min and was stored at -70t.3. MeasurementStandard curve is founded after the reconstruction, adding sam-ple, abstersion, enzyme -linked antibody adding, abstersion, tinct and terminate, then PS and PAI - 1 of sample groups can be deter-mined by the standard curve.4. Statistical analysisPSData are presented as the frequency and the mean ?standard deviation by the software of SPSS10.0. The paired t test and x² test a-mong three groups were used to the significance of difference of P < 0. 05.Results1. Clinical characteristics contrasted among three groupsThe characteristic of age were similar among the patients of three groups (p > 0. 05) , but hypertension and typical angina pec tons of PTCA group and GAG positive group differed from the GAG negative group ( p < 0.05 ). There is a significant difference of total serum cho-lesterol and low density lipoprotein(LDL) between PTCA group and GAG positive group to that of GAG negative group( p <0.05).2. Plasma PS and PAI -1 level among three groupsThe plasma PS level 10 minutes after PTCA is significant high than that before PTCA and GAG negative group ( P < 0. 05 ) , while there is no difference between the level of ps 24 hours after PTCA and that before PTCA. The plasma PAI - 1 level before PTCA of PTCA group and GAG positive group is significantly high than that of GAG negative group (P <0.01) , and there is no difference between before PTCA and after PTCA in plasma PAI - llevel.DiscussionAcute coronary syndrome is the hotspot fields so far and is one of the most important methods of angioplasty. On the othe...