远隔缺血后适应对急性心肌梗死再灌注治疗患者血小板功能的影响

摘要

Objective To investigate the effect of remote ischemic postconditioning (RIPostC ) on the platelet reactivity in the patients with acute myocardial infarction (AMI) receiving reperfusion therapy .Methods Seventy-one cases of AMI entering the group received the reperfusion therapy .The patients were divided into the two groups .The treatment group received RIPostC ,while the control group received sham RIPostC .The venous blood samples were collected before transcutaneous coronary intervention (PCI) ,instantly after RIPostC and at 24 h ,48 h after PCI .The platelet activation indicators CD62P and PAC-1 ,and platelet apopto-sis indicator mitochondrial transmembrane potential(ΔΨm) were measured by flow cytometry .Results CD62P expression on plate-let surface at 24 h after PCI in the treatment group was significantly lower than that in the control group (P<0 .05) ,but which at other time points had no statistical difference between the two groups (P>0 .05);there was no statistical difference in platelet PAC-1 expression at each time point between the two groups (P>0 .05);the platelet ΔΨm at each time point had no statistical difference between the two groups(P>0 .05) .Conclusion RIPostC can somewhat reduce platelet activation in AMI patients without causing platelet early apoptosis .%目的 探讨远隔缺血后适应(RIPostC)对急性心肌梗死再灌注治疗患者血小板功能的影响.方法 入组2015年6月至2016年7月该院71名急性心肌梗死患者,均接受再灌注治疗.患者分为两组:处理组,接受RIPostC;对照组,接受假RI-PostC.在经皮冠状动脉介入术(PCI)之前、RIPostC后即刻、PCI术后24 h、PCI后48 h采集患者的静脉血样,用流式细胞仪检测血小板活化指标CD62P和PAC-1,和血小板凋亡指标线粒体跨膜电位(ΔΨm).结果 处理组PCI术后24 h血小板表面CD62P的表达明显低于对照组(P<0.05),而在其他时间点两组差异无统计学意义(P>0.05);两组血小板PAC-1表达在各个时间点差异无统计学意义(P>0.05);两组患者血小板 ΔΨm在各时间点差异也无统计学意义(P>0.05).结论 RIPostC能一定程度降低急性心肌梗死患者血小板的活化,不引起血小板早期凋亡.