凝血及纤溶系统变化在急性心肌梗塞溶栓治疗中的作用

The role of changes of coagulative and fibrinolytic parameters in the patients with acute myocar- dial infarction during thrombolytic therapy

本文通过对急性心肌梗塞(AMI)早期溶栓治疗的43例患者进行凝血及纤溶系统功能的测定,分别在溶栓前、溶栓后4h、12h、24h、48h及1周测定凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)、纤溶酶原(PLG)、α_2抗纤溶酶(α_2AP)、纤维蛋白原(Fg)、D二聚体含量(D=Dimer)、组织型纤维溶酶原活化物(t-PA)、组织型纤溶酶原活化物抑制物(PAI),其结果显示,溶栓组冠脉再通26例(60.5%),溶栓前与溶栓后4h相比冠脉再通组t-PA活性明显高于未通组(P<0.01),PLG活性及Fg含量的降低幅度再通组明显高于未通组,建议溶栓中应把测定t-PA、PAI、PLG及Fg作为判断溶栓治疗效果的指标.

The parameters of coagulative and fibrinolytic were examined from 47 patients with acute myocardial infarction during thrombolytic therapy. Before and 4h, 12h, 24h,48h, and 1 week after the thrombolytic therapy, prothrombin time (PT), actived partial thromboplasmin time (APTT), plasminogen (PLG), a2 antiplasmin (α2AP), tissue type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI), fibrinogen (Fg) and D-Dimer concentration were determined in all cases. The results were as follows: after thrombolytic therapy 26 cases (60. 5%). had coronary artery reperfusion, 48h after thrombolytic therapy t-PA activity significantly higher in patients with coronary artery reperfusion than in cases with non-reperfusion (P<0. 01). Decrease of PLG activity and Fg concentration significantly higher in reperfusion group than non-reperfusion. The results suggest monitoring t-PA, PA1, PLG and Fg might play a important effect during thrombolytic therapy.