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目的探讨静脉溶栓及经皮腔内冠状动脉成形术(PTCA)治疗急性心肌梗死对P选择素的影响。方法将治疗急性心肌梗死患者分为静脉溶栓治疗成功组40例、PTCA治疗成功组45例及静脉溶栓治疗失败组25例,并在静脉溶栓及PTCA前、治疗后2、4、8、12、24、48小时分别检测可溶性P选择素水平。结果各组P选择素均在治疗2小时后升高,而静脉溶栓成功组及PTCA组P选择素在12小时内回落至基线水平;PTCA成功组明显比静脉溶栓组P选择素提前达到高峰,亦提前回落至基线水平;静脉溶栓失败组P选择素24小时后仍持续高水平。结论可溶性P选择素在急性心肌梗死患者再灌注后是明显升高的,且有明显的动态变化,可以作为血管再通标志之一。
Objective To investigate the effect of intravenous thrombolysis and percutaneous transluminal coronary angioplasty (PTCA) on P-selectin in patients with acute myocardial infarction. Methods The patients with acute myocardial infarction were divided into 40 cases of successful thrombolytic therapy group, 45 cases of successful PTCA treatment group and 25 cases of failure of intravenous thrombolytic therapy. Before intravenous thrombolysis and PTCA, 2,4,8 , 12,24,48 hours were detected soluble P-selectin levels. Results P-selectin in all groups increased 2 hours after treatment, while P-selectin in successful venous thrombolysis group and PTCA group returned to baseline within 12 hours; P-selectin in PTCA successful group was significantly earlier than that in intravenous thrombolysis group Peak, also dropped to the baseline level in advance; failed intravenous thrombolysis P-selectin 24 hours after the continued high level. Conclusion Soluble P-selectin in patients with acute myocardial infarction after reperfusion was significantly increased, and significant dynamic changes, can be used as one of the signs of recanalization.