急性心肌梗死患者组织因子活性和凝血酶-抗凝血酶复合物的变化及临床意义

Clinical significance and change of activity of tissue factor and thrombin-antithrombin complexes in patients with acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者血浆组织因子(TF)活性及凝血酶-抗凝血酶(TAT)复合物血浆水平及临床意义。方法采用发色底物法和酶联免疫吸附测定检测了AMI30例、不稳定型心绞痛(UA)27例,胆囊炎及健康人各30例的TF活性及TAT。结果AMI组[TF活性(258±111)pmol/L和TAT(28.4±3.6)μg/L]显著高于对照组[TF活性(110±50)pmol/L和TAT(6.6±3.4)μg/L]、UA组[TF活性(121±49)pmol/L和TAT(9.8±5.6)μg/L]、胆囊炎组[TF活性(143±33)pmol/L和TAT(5.9±2.1)μg/L](P均<0.01)。结论监测血浆TF活性和TAT的变化,有助于判断AMI和UA患者是否存在由高浓度TF触发的凝血途径激活及有无凝血酶生成引发的血液高凝状态。

Objective To investigate the clinical significance and change of the plasma levels of activity of tissue factor（TF） and thrombin-antithrombin（TAT） complexes in patients with acute myocardial infarction（AMI）. Methods The plasma levels of activity of TF and TAT [n 30 patients with AMI, 27 patients with unstable angina（UA）, 30 patients with cholecystitis and 30 healthy controls were assayed by chromogenic assay and enzyme-linked immunosorbent assay（ELISA） respectively. Results [activity of TF （258±111） pmol/L, TAT level（28.4±3.6） μg/ L] in AMI group were significantly higher than those of control [activity of TF （110±50） pmol/L, TAT level（6.6±3.4） μg/L],UA group [activity of TF （121±49） pmol/L,TAT level（9.8±5.6） μg/L], cholecystitis group [activity of TF （143± 33） pmol/L, TAT level（5.9 ± 2.1）μg/L]（all P 〈0.01）. Conclusion The measurement of plasma levels of activity of TF and TAT is helpful to estimate whether TF triggers activation of coagulation pathway and TAT triggers the hypercoagulability.