Rubenfire M, Blevins R D, Barnhart M, Housholder S, Selik N, Mammen E F
Am J Cardiol. 1986 Mar 1;57(8):657-60. doi: 10.1016/0002-9149(86)90854-4.
Forty-one patients with chest pain and angiographically normal coronary arteries were studied for platelet abnormalities. Patients with conditions known or suspected to be associated with chest pain or platelet dysfunction were excluded. After coronary angiography and 2-week withdrawal from all medications, platelet aggregometry was performed using peripheral venous plasma samples and 3 concentrations of adenosine diphosphate, 2.34, 1.17 and 0.58 microM, and epinephrine, 11, 1.1 and 0.55 microM, as stimuli. Platelet morphology in response to surface contact (adhesion) was evaluated by transmission electron microscopy to determine the percentage of platelets in the round/abortive (inactive), dendritic (intermediate) and spread (activated) forms. Plasma specimens obtained from healthy volunteers of similar age and sex were analyzed in parallel and served as control subjects. Compared with control subjects, patients had increased aggregation at all concentrations of both adenosine diphosphate and epinephrine (p less than 0.001). Patients also had fewer platelets in the dendritic form and more in the round/abortive and spread forms. Thus, patients with chest pain and normal coronary arteries have platelet hyperaggregability in vitro, although the clinical relevance of this finding is unclear.
对41例胸痛且冠状动脉造影正常的患者进行了血小板异常研究。已知或疑似与胸痛或血小板功能障碍相关的患者被排除。在冠状动脉造影及停用所有药物2周后，使用外周静脉血浆样本以及2.34、1.17和0.58微摩尔/升3种浓度的二磷酸腺苷和11、1.1和0.55微摩尔/升肾上腺素作为刺激物进行血小板聚集测定。通过透射电子显微镜评估血小板对表面接触（黏附）的形态，以确定圆形/发育不全（无活性）、树突状（中间）和伸展（活化）形态的血小板百分比。同时分析了年龄和性别相似的健康志愿者的血浆样本作为对照。与对照相比，患者在所有浓度的二磷酸腺苷和肾上腺素下的聚集均增加（p<0.001）。患者树突状形态的血小板也较少，而圆形/发育不全和伸展形态的血小板较多。因此，胸痛且冠状动脉正常的患者在体外具有血小板高聚集性，尽管这一发现的临床意义尚不清楚。
