Rao A K, Mintz P D, Lavine S J, Bove A A, McDonough M T, Spann J F, Walsh P N
Circulation. 1984 Jan;69(1):15-21. doi: 10.1161/01.cir.69.1.15.
Platelets have been implicated in the pathogenesis of coronary artery disease, and a number of studies have examined platelet function and coagulation parameters in such patients. We have examined platelet coagulant activities, volumes, and aggregate ratios in 23 patients with chest pain, seven of whom had normal coronary angiograms (group I) and 16 of whom had angiographically proven coronary artery disease (group II). There were no significant differences in the mean values for platelet volume or platelet aggregate ratios between the two groups. The platelet coagulant activities concerned with initiation and the early stages of intrinsic coagulation were significantly increased in patients in group II as compared with those in group I. No significant differences were noted between the two groups with respect to prothrombin time, partial thromboplastin time, and plasma levels of fibrinogen and coagulation factors V and VIII. However, the mean activity in plasma of antithrombin III (but not the level of antithrombin III antigen) was significantly lower in patients of group II compared with group I. Overall, our observations provide evidence for an enhanced contribution of platelets to the intrinsic coagulation system in patients with coronary artery disease. The platelet coagulant hyperactivity noted in these patients may reflect a role of platelets in the pathogenesis of coronary artery disease or may be secondary to the underlying arterial disease.
血小板与冠状动脉疾病的发病机制有关，许多研究已对这类患者的血小板功能和凝血参数进行了检测。我们检测了23例胸痛患者的血小板凝血活性、体积和聚集率，其中7例冠状动脉造影正常（I组），16例经血管造影证实患有冠状动脉疾病（II组）。两组之间血小板体积或血小板聚集率的平均值无显著差异。与I组患者相比，II组患者中与内源性凝血起始和早期阶段相关的血小板凝血活性显著增加。两组在凝血酶原时间、部分凝血活酶时间以及纤维蛋白原、凝血因子V和VIII的血浆水平方面未发现显著差异。然而，与I组相比，II组患者抗凝血酶III的血浆平均活性（而非抗凝血酶III抗原水平）显著降低。总体而言，我们的观察结果为冠状动脉疾病患者血小板对内源性凝血系统的贡献增强提供了证据。这些患者中观察到的血小板凝血活性过高可能反映了血小板在冠状动脉疾病发病机制中的作用，也可能是潜在动脉疾病的继发表现。
