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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2017年第2期

页码:

164-167,175

栏目:

临床研究

出版日期:

2016-11-25

文章信息/Info

Title:

Correlation between residual platelet agglutination and chemokine CCL2 in patients with ST elevated myocardial infarction after clopidogrel treatment

作者:

曹 禹¹; 2; 张效林²; 刘 丹²; 高乃婧²

(1.第四军医大学西京医院心内科，陕西 西安 710032；
2.沈阳军区总医院心血管病研究所，辽宁 沈阳 110016)

Author(s):

CAO Yu¹; 2;  ZHANG Xiao-lin²;  LIU Dan²;  GAO Nai-jing²

(1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China；
2.Cardiovascular Research Institute, General Hospital, Shenyang Military Area Command, Shenyang 110016, Liaoning, China)

关键词:

趋化因子CCL2; 残余血小板聚集率; 氯吡格雷; 心肌梗死; ST段抬高型

Keywords:

CCL2;  residual platelet agglutination;  clopidogrel;  ST elevated myocardial infarction

分类号:

R543.3

DOI:

-

文献标识码:

A

摘要:

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。

Abstract:

AIM To explore the correlation between residual platelet agglutination (RPA) and plasma chemokine CCL2 concentration in patients with ST elevated myocardial infarction (STEMI) 4-6 h after taking clopidogrel. METHODS We enrolled 107 STEMI patients and each patient took clopidogrel (600 mg) and aspirin (300 mg) orally. Approximately 6 ml of venous blood was drawn 4-6 h after taking clopidogrel. We tested RPA using TPA and detected plasma CCL2 concentration using ELISA. Patients were divided into two groups: high platelet reactivity group and normal platelet reactivity group. The cutoff value was 59%. General data and clinical trial data were collected. RESULTS Fifty-one patients were in the high platelet reactivity group and 56 patients were in the normal platelet reactivity group. Age, gender, smoking history, hypertension history, diabetes mellitus history, FG, TC, TG, HDL-C, LDL-C and BNP were not significantly different between groups. There was a linear correlation between RPA and plasma CCL2 concentration in the 107 STEMI patients (r=0.427, P<0.01). Plasma CCL2 concentration was significantly different between groups (P<0.01). Plasma CCL2 concentration was, respectively (243±80) ng/L in high platelet reactivity group and (171±44) ng/L in normal platelet reactivity group. TNT and CK-MB levels in high platelet reactivity group were, respectively, higher than those in the normal platelet reactivity group ［(3.1±2.3) U/L vs.(2.3±1.4) U/L; (198±16) μg/L vs.(151±13) μg/L; both P<0.05］. CONCLUSION A linear correlation exists between RPA and plasma CCL2 concentration.

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备注/Memo

备注/Memo:

收稿日期：2016-01-19.
基金项目：国家自然科学基金青年项目资助（81500282）
通讯作者：张效林，副主任医师，主要从事冠心病防治的基础研究 Email:xiaolindianyu75@163.com
作者简介：曹禹，主治医师，博士生 Email:48830126@qq.com

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更新日期/Last Update: 2016-10-11