【作者】 刘海波；

【导师】 陈在嘉； 高润霖；

【作者基本信息】 中国协和医科大学 ， 冠心病， 1994， 博士

【摘要】 血小板与血管壁之间相互作用可能是缺血性心脏病发生（发展）的重要因素之一。本研究通过测定患者冠状循环中血小板功能及前列腺素等的变化，从以下几个方面探讨了它们在冠心病不同情况下的作用及抗血小板药物等对它们的影响。 一、冠心病不同临床类型患者冠状循环中血小板功能及前列素等的变化 于47例受试对象，同时采集冠状静脉窦（CS）及升主动脉（AO）血进行血浆及血清血栓烷B₂[TXB₂，血栓烷A₂（TXA₂）的稳定代谢产物]及6-酮前列腺素F_1α（前列环素的稳定代谢产物）的测定，部分患者同时进行了血浆cAMP及血小板聚集的测定。结果为，不稳定型心绞痛（UA）患者及急性心肌梗塞（AMI）患者的血浆TXA₂ CS／AO比值明显高于正常对照组及稳定型心绞痛患者（SA）。SA、UA及AMI患者血清TXB₂ CS／AO比值均明显低于正常对照组。UA患者血浆cAMP CS／AO比值明显低于SA及正常对照组。UA患者CS中血小板聚集性明显低于AO中者，而正常对照组中却无明显差别。结果提示，UA及AMI更多还原

【Abstract】 The interaction between platelet and vessel wall may play an i（?）portant role in the development of ischemia heart disease （IHD）. In our research,we measured changes in platelet function and release of prostaglandins in coronary circulation to further study their propable role in different patterns of IHD.1.Changes in platelet function and prostaglandins levels in coronary circulation in patients with different clinical types ofIHDSimultaneous coronary sinus （CS） and ascending-aorta （AO） blood samples were obtained from 47 patients for measurement of plasma and serum thromboxane B₂ [TXB₂, a stable metabolite of thromboxane A₂ （IXA₂）] and of 6-keto-prostaglandin F₁a [ 6-keto-PGF₁a , a stable netabolite of prostacyclin I₂ （PGI₂）]. Samples from some of these patients were also tested for platelet aggregation and plasma. cAMP. The results showed （1） patients with unstable angina pectoris （UA） and acute myocardiol infarction （AMI） had higher plasma TXB₂ CS/AO ratios （1.66±0.20 and 2.32 ±0.47, respectively） than patients with stable angina （SA） and control subjects （1.04±0.17 and 1.00±0.06, respectively） （p<0.05）; （2） serum TXB₂ CS/AO ratios in patients with SA, UA or AMI were significantly lower when compared with control subjects; （3）plasma cAMP CS/AO ratios were lower in patients with UA than those in patients with SA or control subjects; （4）platelet aggregation in CS blood significantly decreased than that in A0 blood in patients with UA,but there was no difference in platelet function between A0 and CS in control subjects; （5） no significant differences更多还原