Teysseire N, Lévy P Y, Valeix B, Labrunie P, Lévy G
Laboratoire d'analyses médicales, Centre cardiovasculaire, La Casamance, Aubagne, France.
Ann Biol Clin (Paris). 1995;53(3):135-40.
Coronarography and intraluminal angioplasty induce platelet activation. In this study, activated platelets were evaluated by measuring platelet-bound fibrinogen using a polyclonal fluorescent antibody in flow cytometry on whole blood. For normal subjects, the percentage of platelets binding fibrinogen was low (16.67%) and reached 81.0% in response to ADP. The percentages of platelets binding fibrinogen were evaluated 24 hours before and after coronarography. During intracoronary angioplasty, blood was collected from the catheter before and after the dilation and aspirin bolus (1 g). In both groups, the percentages of activated platelets were lower compared with those of the control group (respectively 3.96% and 5.59% versus 16.67%) following aggregation inhibitor, anticoagulant and calcium inhibitor therapies. Twenty-four hours after coronarography, platelet activation was noted (9.71% versus 3.96%). During angioplasty no significant activation was observed immediately after dilation (6.54% versus 5.59%). In both groups before the intervention, ADP stimulation was still responsible for platelet activation but to a lesser extent than in the control group (60.42% and 66.31% versus 81.0%). After coronarography, the platelet response to ADP was identical to that in the control group (81.01% versus 81.0%). Immediately after dilation, this activation was not observed in patients with an angioplasty. This study shows that platelet activation occurs 24 hours after coronarography, whereas after dilation and an aggregation inhibitor bolus this activation is not observed during angioplasty.
冠状动脉造影术和腔内血管成形术可诱导血小板活化。在本研究中，通过使用多克隆荧光抗体在全血流式细胞术中测量血小板结合的纤维蛋白原来评估活化血小板。对于正常受试者，结合纤维蛋白原的血小板百分比很低（16.67%），而在ADP刺激下达到81.0%。在冠状动脉造影术前后24小时评估结合纤维蛋白原的血小板百分比。在冠状动脉腔内血管成形术期间，在扩张和给予阿司匹林推注（1g）前后从导管采集血液。在两组中，在使用聚集抑制剂、抗凝剂和钙抑制剂治疗后，活化血小板的百分比均低于对照组（分别为3.96%和5.59%，而对照组为16.67%）。冠状动脉造影术后24小时，观察到血小板活化（9.71%，而之前为3.96%）。在血管成形术期间，扩张后立即未观察到明显的活化（6.54%，而之前为5.59%）。在干预前的两组中，ADP刺激仍可导致血小板活化，但程度低于对照组（分别为60.42%和66.31%，而对照组为81.0%）。冠状动脉造影术后，血小板对ADP的反应与对照组相同（81.01%，而对照组为81.0%）。在血管成形术患者中，扩张后立即未观察到这种活化。本研究表明，血小板活化发生在冠状动脉造影术后24小时，而在扩张和给予聚集抑制剂推注后，在血管成形术期间未观察到这种活化。
