溶栓治疗对急性心肌梗塞患者纤溶系统功能的影响

Effects of Thrombolytic Drugs on Fibrinolytic System in Patients with AMI

本文通过观察纤溶系统活性,纤维蛋白原(Fg)、纤维蛋白降解产物(FDP)含量变化,探讨蛇毒抗栓酶(SVATE)、UK溶栓治疗对急性心肌梗塞(AMI)的临床意义。结果表明,静脉一次大剂量UK治疗,患者血浆PL、ELA、t-PA活性和FDP出现快速大幅度增高,PAI、Fg降低、这种作用仅持续短时间、SVATE静脉首次大剂量以后小剂量维持2周处理,血浆上述纤溶指标逐渐恢复,ELA、t-PA和PAI活性2～3周接近正常水平。结果提示,SVATE、UK溶栓治疗使AMI患者纤溶功能得到改善,若采用二者联合用药,效果可能更理想。

The changes of fibrinolytic activity and effects of thrombolytic drugs were investigated in plasma of 54 patients with AMI. The activity of t-PA, Plasmin (PL) andELA were significantly decreased (respectively P<0.05, 0.01, 0.05 vs 23 health subjects) , on the contrary, PA inhibitor (PAI) activity were increased (P<0.01)SVATE, iv 2.5 U/day for 2 weeks, gradually increased t-PA, PL, ELA activity and FDP content but decreased PAI and Fg in 13 AMI. The effects of fibrinolysis above were recovered to normal level during 2-3 weeks with SVATE. UK,iv 1000000 U once, induced a big immediate and transient changes in fibrinolytic activity in 14 AMI. On the contrary, treatment of routine caused the slow changes in fibrinolytic activity. These results suggested that the effects of SVATE in fibrinolysis was not so great as that UK at early stage of AMI and combined treatment with both SVATE and UK may be effective in AMI.