摘要
目的观察急性缺血性心、脑血管疾病发作期间组织因子途径的变化及其临床意义。方法观察对象包括69例急性心肌梗死(AMI),71例急性脑梗死患者以及50例健康成人。血浆中组织因子(TF)和组织因子途径抑制物(TFPI)活性测定采用发色底物法,抗原测定用ELISA法;凝血因子Ⅶ(FⅦ)促凝活性测定采用一期凝固法,FⅦa水平测定采用重组可溶性组织因子法,凝血酶原(FⅡ)及纤维蛋白原(Fbg)相对活性分别采用发色底物法及凝血酶时间法测定。结果与对照组相比,AMI患者血浆中TF活性、TF抗原、TFPI活性与TFPI抗原和FⅦa均显著增加(P<0.01),而血浆中FⅦ:C无显著变化(P>0.05),FⅡ及纤维蛋白原(Fbg)亦显著增加(P<0.01);急性缺血性脑卒中(AICS)患者血浆中TF活性、TF抗原均升高(P均<0.01),TFPI活性、TFPI抗原均降低(P<0.05),而血浆中FⅦ:C、FⅦa、FⅡ及纤维蛋白原显著增加(P均<0.01)。两病例组比较,AMI组TF活性、抗原及纤维蛋白原升高更为显著(P<0.01);AMI组TFPI活性、抗原增加,而AICS组均降低,差异具有显著性意义(P<0.01),FⅦ:C在AICS组显著升高(P<0.01),而血浆FⅦa及FⅡ两组差异并无显著性(P>0.05)。结论AMI和AICS的发生存在组织因子途径的启动,但其组织因子途径改变并不相同,患者内皮功能受损,血液存在一定的高凝倾向。
Objective To explore the changes and clinical significance of plasma tissue factor pathway (TFP) levels during the onset of acute ischernic cardiac and cerebral vessel disease, Methods The study population consisted of 69 patients with AMI and 71 with AICS as well as 50 age-matched healthy volunteers. Blood samples were obtained during the onset period of AMI and AICS. Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) activity in plasma were assayed with the chromogenic assay, Plasma TF and TFPI antigen were measured with ELISA, Plasma FⅦ coagulation activity (FⅦC) was developed in the one- stage system. Plasma FⅦa was determined by soluble TF assay, plasma prothrombin (FⅡ) and fibrinogen (Fbg) were measured by one-stage amidolytic assay and thrombin time (TT) respectively. Results In the AMI group, compared with the control group, plasma TF activities and antigens, TFPI activities and antigens as well as FⅦa were significantly higher(all P〈0.01), but FⅦ :C was not different from those in the controls (P〉0. 05), plasma FⅡ and Fbg were also remarkably increased (both P〈0. 01) ; while in the AICS group, compared with the control group, plasma TF activities and antigens were obviously higher (both P〈0. 01), but the activities and antigens of plasma TFPI were decreased (both P〈0. 05), both F :C activity and FⅦa were remarkably higher (both P〈0. 01), and plasma FII and Fbg were also significantly increased (both P〈 0. 01). Between AMI and AICS group, the increments of TF activities and antigens as well as Fbg were markedly higher in AMI than those in AICS (P〈0. 01), plasma TFPI activities and antigans were significantly increased in AMI (P〈0. 01), but remarkably decreased in AICS (P〈0. 01), plasma FⅦ :C activity obviously increased in AICS than those in AMI(P〈0. 01), and there were no statistical differ ence for FⅦa and FII between AMI and AICS (P〉0. 05). Conclusion The initiation of TF pathway would be associated with the onset of AMI and AIS, but the changes of TF, TFPI, FⅦ :C and Fbg in AMI are different from those in AICS, endothelial dysfunction and the blood is in hypercoagulable state.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2008年第1期93-95,共3页
Medical Journal of Chinese People's Liberation Army
基金
国家自然科学基金资助项目(39830180)
关键词
急性心肌梗死
脑血管意外
组织因子途径
内皮损伤
acute myocardial infarction
cerebrovascular accident
tissue factor pathway
endothelial dysfunction