| Objective: To investigate the changes and clinical significance of the expression of P-selectin, GlycoproteinⅡb/Ⅲa (GPⅡb/Ⅲa) receptor and the platelet aggregation rate before and after percutaneous coronary intervention(PCI) in patients with coronary heart disease (CHD) and suspicious CHD;and to the relationship between MACE and above factors .Methods: From December 2006 to January 2007, 60 patients( 30 male and 30 female, age 50.46±4.03 years ) who hospitalized in our department and received CAG/PCI were enrolled in our study. According to the results of angiograghy, 26 patients with coronary artery lumen diameter stenosis more than 70% and underwent PCI were group A, 19 with similar angiograghy but had not received PCI were group B and 15 angiograghically normal patients were group C; all the CHD patients(group A and B) were also divided into AMI group and UA group according to their dingnosis; group A was divided into MACE group and NON-MACE group according to their MACE events happened or not. Exclusion criteria were: acute infection, tumour, pulmonary infarction, diabetes mellitus, general immunity diseases, renal or liver dysfunction, hematological system diseases, peripheral vascular disease, take anti-inflammatory agent or adrenocortical hormone in the near future; myocarditis, endocarditis, heart valves diseases, congestive heart failure, hypertensive disease , atrial fibrillation, emergency PCI or thrombolysis, cardiomyopathy, stable angina pectoris, CHD with coronary artery stenosis between 50～70% or not suitable for PCI , Prinzmetal's variant angina pectoris, CHD with application of tirofiban. Age,gender,smoking,family history were recoded in every patients in detail. At the same time, biochemical and physical examination were checked up, such as LDL,leucocyte,electrocardiogram(ECG)and X-rays. Oral drugs such as aspirin,ACEI,clopidogrel,nitroglycerin,statins and low molecular heparin were used in patients according to their condition. All the patients underwent CAG/PCI after 3-7day's medical treatment. Peripheral blood samples were drawn 1h before CAG and 30min, 3h, 12h after CAG/PCI. P-selectin and GPⅡb/Ⅲa receptor were measured by flow cytometer(FACS Vantage) with Cell Quest software within 2 hours. The platelet aggregation rate(PAR) were measured by PRECIL LBY-NJ4 within 1 hours. After the procedure, group A and B continued their standard medical treatment for CHD and group C stopped. The statistical analysis was performed by the Statistical Package for Social Sciences software(SPSS 11.5 for Windows). A P-value <0.05 was considered statistically significant.Result:①There was no significance in clinical and interventional features among group A,B and C. There was no significance in constituent ratio of AMI and UA in group A and B (P=0.815).②Before CAG/PCI, P-selectin, GPⅡb/Ⅲa receptor and PAR were significantly higher in group A and B than those in group C(P<0.01).③Before CAG, P-selectin, GPⅡb/Ⅲa receptor and PAR were significantly higher in AMI group and UA group than those in group C(P<0.01). The tend of above parameters was the same between AMI group and UA group (P<0.01).④P-selectin, GPⅡb/Ⅲa receptor and PAR level showed a significanct increase at the time of 30min after PCI in group A than before (P<0.01), while without significiant changes in group B and C during pre- and procedure.⑤After follow-up there are 5 patients happened MACE in group A . The level of the P-selectin, GPⅡb/Ⅲa receptor and PAR are more higher than those who did not happen MACE.Conclusion:①PCI may induced greater activation of platelet and vulnerability of blood, the peripheral blood level of P-selectin, GPⅡb/Ⅲa receptor and PAR increased in the patients who undertwent PCI. However, the CAG did not affect these three parameters before and after the operation;②Increased P-selectin, GPⅡb/Ⅲa receptor and PAR were associated with the late MACE after PCI.③The peripheral blood level of P-selectin, GPⅡb/Ⅲa receptor and the PAR associated with clinical severity, which were increased in AMI/UA patients.
|
PDF Full Text Request