BIOCHEMICAL-EVIDENCE OF PLATELET ACTIVATION IN PATIENTS WITH PERSISTENT UNSTABLE ANGINA
BIOCHEMICAL-EVIDENCE OF PLATELET ACTIVATION IN PATIENTS WITH PERSISTENT UNSTABLE ANGINA
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DOI：
10.1016/s0735-1097(87)80336-4
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发表时间：
1987-11-01
影响因子：
24
通讯作者：
WEBER, PC
中科院分区：
文献类型：
--
作者：
HAMM, CW;LORENZ, RL;WEBER, PC
活化的血小板释放的血栓素和血管壁的前列环素可能是血小板聚集性和冠脉紧张性的强大拮抗调节剂。因此，我们研究了16例静息心绞痛患者尿液中其主要代谢产物2，3-二诺-血栓素B2和2，3-二-6-酮前列腺素F1α的排泄。在积极的抗心绞痛治疗48小时内，10名患者的病情没有改善，其血栓素代谢产物的排泄量高于治疗有效的6名患者(2,208。+-)。1,542对609。+-。312 ng/g肌酐；p<；0.01)。在8名持续梗死后心绞痛患者中，有4名患者的心绞痛指数升高。血栓代谢物排泄增强常常与血栓形成的血管造影证据有关。当9名患者在11。+-后重新研究时处于稳定期。5个月时，血栓素代谢产物排泄量始终为正常或高正常。所有患者的前列环素代谢产物排泄均未受到抑制，但与血栓素呈弱相关(r=0.41)。因此，血栓素生成增加作为血小板活化的一个指标，可以识别出活动性血栓形成的患者，他们可以从血小板抑制治疗中获益最多。
Thromboxane released from activated platelets and prostacyclin of the vessel wall may act as potent antagonistic modulators of platelet aggregability and coronary vascular tone. Therefore, urinary excretion of their major metabolites, 2,3-dinor-thromboxane B2 and 2,3-dinor-6-ketoprostaglandin F1.alpha., was studied in 16 patients presenting with prolonged angina at rest. The 10 patients whose condition did not improve under vigorous antianginal treatment with 48 hours exhibited higher thromboxane metabolite excretion than did the 6 patients who responded to therapy (2,208 .+-. 1,542 versus 609 .+-. 312 ng/g creatinine; p < 0.01). Elevated values were also found in four of eight patients with sustained postinfarction angina. Enhanced thromboxane metabolite excretion was frequently associated with angiographic evidence of thrombus formation. When nine patients were restudied in a stable phase after 11 .+-. 5 months, thromboxane metabolite excretion was consistently normal or high normal. Excretion of prostacyclin metabolites was not depressed in any patient but correlated weakly with thromboxane (r = 0.41). Thus, enhanced thromboxane production as an index of platelet activation may identify patients with active thrombus formation who could benefit most from platelet inhibitory treatment.