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利用抗人活化血小板α颗粒膜蛋白140(GMP-140)特异的单抗SZ-51和S_(12),研究了15例接受溶栓和15例接受抗凝治疗的急性心肌梗塞(AMI)患者的血小板活化和破坏程度,并做了相应的体外试验,同时也观察了两组患者的临床指标和血清心肌酶的变化。结果表明:AMI患者治疗前,血小板膜表面GMP-140分子数及血浆内GMP-140浓度均明显增高。血小板膜表面GMP-14O分子数于治疗后第1天开始下降,第7天恢复至基础水平;血浆内GMP-40浓度于治疗后第1天达高峰,第2天开始下降,第3天恢复至基础水平。溶栓组和抗凝组治疗前后各时间点以上两指标的变化差异无显著性。溶栓剂尿激酶(UK)与血小板在体外单独作用,未发现它可以激活血小板及抑制血小板的活性。与抗凝组比较,溶栓组冠脉再通率提高,CK及CK-MB峰值前移,左室射血分数(LVEF)明显改善,心电图ST段回降率及胸痛缓解率增高,梗塞并发症(室颤、左心衰、心绞痛)有下降趋势。GMP-140与心肌酶的相关分析表明两者呈正相关,且差异有显著性。
Fifteen patients with thrombolytic therapy and 15 with acute myocardial infarction (AMI) receiving anticoagulant therapy were studied using S-51 and S-12 monoclonal antibodies specific to GMP-140. Platelet activation and destruction, and did the corresponding in vitro tests, but also observed the clinical indicators of both groups of patients and changes in serum myocardial enzymes. The results showed that the number of GMP-140 and the concentration of plasma GMP-140 in platelet membrane of AMI patients before treatment were significantly increased. The number of GMP-14O on the surface of platelet membrane began to decrease on the first day after treatment and recovered to the basal level on the 7th day. The plasma GMP-40 concentration peaked on the first day after treatment, decreased on the second day and recovered on the third day To the basic level. Thrombolysis group and anticoagulant group before and after treatment at any time point above two indicators no significant difference. Thrombolytic agent urokinase (UK) and platelets in vitro alone, did not find it can activate platelets and inhibit platelet activity. Compared with the anticoagulation group, thrombolysis group increased the rate of coronary recanalization, CK and CK-MB peak forward, left ventricular ejection fraction (LVEF) was significantly improved, ECG ST segment regression rate and chest pain relief rate, infarction complicated Symptoms (ventricular fibrillation, left heart failure, angina) have a downward trend. Correlation analysis between GMP-140 and myocardial enzymes showed a positive correlation between the two and the difference was significant.