Kristensen S D, Bath P M, Martin J F
Department of Medicine, King's College School of Medicine and Dentistry, London.
Cardiovasc Res. 1990 Jan;24(1):19-23. doi: 10.1093/cvr/24.1.19.
STUDY OBJECTIVE - The objective was to measure platelet function in vivo (as cutaneous bleeding time), the role of catecholamines, and the effect of inhibiting thromboxane synthesis on bleeding time, in patients with myocardial infarction, unstable angina, and non-cardiac chest pain. DESIGN - Haemotological variables and plasma catecholamines were compared between patient diagnostic groups using the Kruskal-Wallis test, Conover's multiple comparison test, and Wilcoxon paired rank sum test. PATIENTS - 49 patients entered the study and 45 were assigned to three groups: myocardial infarction (n = 26), unstable angina (n = 9), and non-coronary chest pain (control) (n = 10). There were no significant differences between groups for age or sex. Patients with myocardial infarction smoked more than others. MEASUREMENTS and RESULTS - Compared to the controls, bleeding time in patients with myocardial infarction was shortened, while in unstable angina it was normal. Plasma adrenaline and noradrenaline concentrations were higher in the myocardial infarction group than in the unstable angina and control groups, but were not correlated with bleeding time. Bleeding time was remeasured 2 h after ingestion of 300 mg aspirin and increased in all subjects, especially in those with myocardial infarction, but it remained significantly shorter in the infarct group than in the comparison groups. Plasma adrenaline was inversely correlated with the bleeding time after aspirin in the infarct group. CONCLUSIONS - The shortened bleeding time may be an indicator of an increased prethrombotic tendency present in patients with myocardial infarction but not in those with unstable angina. The effect appears to be mediated by both thromboxane A2 and adrenaline.
研究目的——目的是测量心肌梗死、不稳定型心绞痛和非心脏性胸痛患者的体内血小板功能（如皮肤出血时间）、儿茶酚胺的作用以及抑制血栓素合成对出血时间的影响。设计——使用Kruskal-Wallis检验、Conover多重比较检验和Wilcoxon配对秩和检验对患者诊断组之间的血液学变量和血浆儿茶酚胺进行比较。患者——49名患者进入研究，45名被分为三组：心肌梗死组（n = 26）、不稳定型心绞痛组（n = 9）和非冠状动脉性胸痛（对照组）（n = 10）。各组之间在年龄或性别上无显著差异。心肌梗死患者吸烟比其他人多。测量与结果——与对照组相比，心肌梗死患者的出血时间缩短，而不稳定型心绞痛患者的出血时间正常。心肌梗死组的血浆肾上腺素和去甲肾上腺素浓度高于不稳定型心绞痛组和对照组，但与出血时间无关。摄入300mg阿司匹林2小时后重新测量出血时间，所有受试者的出血时间均增加，尤其是心肌梗死患者，但梗死组的出血时间仍显著短于比较组。梗死组血浆肾上腺素与阿司匹林后的出血时间呈负相关。结论——出血时间缩短可能是心肌梗死患者而非不稳定型心绞痛患者血栓形成前倾向增加的一个指标。这种效应似乎是由血栓素A2和肾上腺素共同介导的。
