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目的通过评估红细胞源微粒(RMPs)和急性冠脉综合征(ACS)发病之间的关联,描述RMPs在急性冠状动脉血栓形成过程中发挥的作用。方法研究对象分ACS组(n=200),其分为急性心肌梗死(AMI,n=100)和不稳定型心绞痛组(UAP,n=100),对照组为非冠心病组(n=100)。获得患者知情同意后,收集ACS组以及对照组的外周血,离心后加入钙离子载体A23187,得到MPs。用特异性红细胞微粒抗体(glycophorine A)标记RMPs,后经流式细胞仪定量分析。在体外,将ACS患者血浆中提取的RMPs加入对照组血浆中,在荧光标记的血栓底物作用下诱导血栓形成并用荧光光度仪检测RMPs的致血栓活性。结果 RMPs水平在ACS的AMI亚组(163×10~2)和UAP亚组(96×10~2)都明显高于对照组(12×10~2,P<0.05)。ACS患者在每一个时间段相对荧光单位较对照组显著提高(P<0.05)。研究结果显示,高浓度的MPs更易导致血栓形成且所需时间较短,差异有统计学意义(P<0.05)。结论 ACS组的外周血中RMPs水平明显升高,提示RMPs参与了ACS的发生、发展过程。MPs诱导的血栓形成峰值前移,提示RMPs可能诱导凝血酶形成,揭示ACS发生急性血栓与RMPs有关。
Objective To describe the role of RMPs in acute coronary thrombosis by assessing the association between erythroid micro particles (RMPs) and the incidence of acute coronary syndrome (ACS). Methods The subjects were divided into ACS group (n = 200), which were divided into acute myocardial infarction (AMI, n = 100) and unstable angina group (UAP, n = 100) ). After obtaining informed consent from patients, peripheral blood of ACS group and control group were collected, and after centrifugation, calcium ionophore A23187 was added to obtain MPs. RMPs were labeled with specific glycophorine A and quantified by flow cytometry. In vitro, RMPs extracted from the plasma of patients with ACS were added to the plasma of the control group, thrombus formation was induced by fluorescence-labeled thrombus substrates and thrombus activity of RMPs was assayed by fluorimetry. Results The levels of RMPs in AMI subgroup (163 × 10 ~ 2) and UAP subgroup (96 × 10 ~ 2) were significantly higher than those in control group (12 × 10 ~ 2, P <0.05). The relative fluorescence units in ACS patients at each time period were significantly higher than those in control group (P <0.05). The results showed that high concentration of MPs more likely to lead to thrombosis and the required time is shorter, the difference was statistically significant (P <0.05). Conclusion The level of RMPs in peripheral blood of ACS group is significantly increased, suggesting that RMPs are involved in the occurrence and development of ACS. MPs induced peak thrombosis forward, suggesting that RMPs may induce the formation of thrombin, revealing acute ACS thrombosis and RMPs.