关键词: 冠状动脉疾病;血管成形术，经腔，经皮冠状动脉;小支;血小板

    摘 要:目的 通过术中采集冠状静脉窦血的方法，探讨冠状动脉内小支架置入术对冠脉循环中血小板功能的影响及临床应用的可行性. 方法 39例冠心病患者经冠状动脉造影证实至少有一支血管狭窄大于等于50%(直径法)，术前进行充分抗血小板治疗后，按置入的支架大小分成直径在2.5～2.75mm之间的小冠脉支架组(15例)和支架直径在3.0～4.5mm之间的对照组(24例)，分别于术前、术中及术后1min和10min采集冠状静脉窦血，放免法测定血浆血小板α-颗粒膜蛋白(GMP-140)及血栓素B2 (TXB2 )的浓度.术后随访6mo，比较两组的临床疗效. 结果 两组在球囊预扩张后即刻各血小板功能指标均轻度增高;支架置入后即刻小支架组GMP-140由术前的(7.55±0.36)μg L-1 升至(9.83±0.78)μg L-1 (P<0.05)，对照组由(7.51±0.34)μg L-1 升至(9.60±0.38)μg L-1 (P<0.05);小支架组TXB2 由术前的(247±27)ng L-1 升至(399±23)ng L-1 (P<0.01)，对照组TXB2 由(233±17)ng L-1 升至(385±19)ng L-1 (P<0.01);支架后10min两组GMP-140降至术前水平，TXB2 有下降趋势.两组组间比较各个时间点血小板活性变化趋势一致，均无差异.两组围手术期均无急性闭塞发生，术后6mo随访，两组临床再狭窄率无显著差异. 结论 对充分抗凝的冠心病患者植入小冠脉支架并不引起更强的血小板活化，血栓发生率低.

    Effects of small stent implantation on platelet func┐tion and clinical outcomes

    CAO Feng，JIA Guo-Liang，GUO Wen-Yi，LI Cheng-Xiang，LI Wei-Jie，LU An-Lin，Wang Xiao-Yan

    Department of Cardiovasology，Xijing Hospital，Fourth Military Medical University，Xi'an710033，China

    Keywords:coronary disease;angioplasty，transluminal，per-cutaneous coronary;platelet function;stents

    Abstract:AIM To assess the effects of small coronary stent implantation on platelet function in the coronary circulation in the patients with coronary heart disease.METHODS 39pa-tients with coronary heart disease underwent PTCA and in-stent implantation.Blood samples were obtained from the coronary sinus immediately before and after stent implanta-tion ......