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目的研究急性心肌梗死(AMI)患者外周血CD62p与血清C-反应蛋白(hscrp)及纤维蛋白原(Fib)水平的变化,探讨它们之间的相关性及对预后的影响。方法采用流式细胞技术测定50例AMI患者外周血CD62p,并与20例正常对照比较;采用乳胶增强免疫透射比浊法测定hscrp,采用Clouse法测定Fib。并对AMI患者进行随访。结果AMI患者的CD62p的表达及hscrp、Fib水平显著高于对照组。AMI患者的CD62p的表达与hscrp呈正相关(r=0.796,P<0.01),CD62p的表达与Fib呈正相关(r=0.598,P<0.01)。AMI患者中心脏事件者(15例,包括随访1年内的再发AMI,再住院行心肌血管重建术,住院期间及随访期间的心源性死亡者)与随访1年内无心脏事件(35例)相比,CD62p表达差异有统计学意义(P<0.05)。结论AMI患者血小板被激活,CD62p的激活与炎症因子hscrp有相关性,血小板激活和Fib交连形成血栓可能都是影响AMI患者病情进展及预后的重要因素。
Objective To study the changes of CD62p, hscrp and fibrinogen (Fib) levels in peripheral blood of patients with acute myocardial infarction (AMI) and explore their correlation and prognosis. Methods Flow cytometry was used to determine the CD62p in peripheral blood of 50 patients with AMI and compared with 20 normal controls. The hscrp was measured by latex enhanced turbidimetry and Fib was detected by Clouse method. AMI patients were followed up. Results The expression of CD62p and the levels of hscrp and Fib in patients with AMI were significantly higher than those in the control group. The expression of CD62p in AMI patients was positively correlated with hscrp (r = 0.796, P <0.01). The expression of CD62p was positively correlated with Fib (r = 0.598, P <0.01). Cardiac events in AMI patients (15 patients, including recurrent AMI within one year of follow-up, myocardial revascularization in rehospitalization, cardiac death during hospitalization and follow-up) were associated with no cardiac events within 1 year of follow-up Compared with CD62p expression, the difference was statistically significant (P <0.05). Conclusion The platelets in AMI patients are activated. The activation of CD62p is correlated with the hscrp inflammatory factor. Platelet activation and thrombus formation by Fib cross-linking may be important factors that affect the progression and prognosis of AMI patients.