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目的：探讨急性心肌梗死（AMI）患者尿激酶溶栓治疗前后血小板活性的动态变化及其与血管早期再通的关系。方法：接受尿激酶静脉溶栓治疗的38例AMI患者在溶栓前及溶栓后2h、6h、12h、24h分别取血测定血浆中α-颗粒膜蛋白（GMP-140），依溶栓前临床间接指标及溶栓后90min冠状动脉造影结果，将患者分为再通组（27例）和未通组（11例），比较两组患者血中GMP-140的动态变化，并设正常对照组。结果：AMI患者溶栓前血浆GMP-140浓度明显高于正常对照组。溶栓后再通组与未通纷呈不同浓度的动态变化，溶栓未通组，GMP-140升高；溶栓再通组，则GMP-140降低，两组溶栓后6h、12h、24h血浆GMP－140浓度差异显著（P＜0．001）。结论：AMI后血小板高度活化，血浆GMP-140与AMI的血栓形成、溶解及再通密切相关，其在溶栓后的迅速下降可望作为临床判断血管再通的新指标。
Objective: To investigate the dynamic changes of platelet activity before and after urokinase thrombolysis in patients with acute myocardial infarction (AMI) and its relationship with early recanalization of blood vessels. Methods: Thirty-eight patients with AMI who received intravenous thrombolysis of urokinase were killed before thrombolysis and 2h, 6h, 12h and 24h after thrombolysis, respectively. Plasma samples were collected for determination of a-granule membrane protein (GMP-140) Clinical indirect index and coronary angiography results 90min after thrombolysis, the patients were divided into reperfusion group (27 cases) and unreasonable group (11 cases). The dynamic changes of GMP-140 in blood were compared between the two groups. group. Results: The concentration of plasma GMP-140 in patients with AMI before thrombolysis was significantly higher than that in the normal control group. After thrombolysis and then pass through the group and did not pass different concentrations of dynamic changes, thrombolysis failed group, GMP-140 increased; thrombolytic recanalization group, the GMP-140 decreased in both groups after 6h, 12h, 24h Plasma GMP-140 concentrations were significantly different (P <0.001). CONCLUSION: The platelet is highly activated after AMI. Plasma thrombosis, dissolution and recanalization of GMP-140 are closely related to AMI. The rapid decline of plasma GMP-140 after AMI is expected to be a new index for clinical judgment of recanalization.