缬纱坦对急性冠状动脉综合征患者凝血及纤溶系统的影响

Effects of valsartan on coagulative and fibrinolytic system in patients with acute coronary syndrome

目的探讨血管紧张素受体拮抗剂对凝血及纤溶系统的影响。方法急性冠状动脉综合征患者60例,随机分为对照组(30例)和缬纱坦组(30例),对照组按临床常规处理,缬纱坦组在此基础上加用缬纱坦80mg/d,分别于入院后即刻和第3天采血测激活的凝血时间(ACT)和血浆组织型纤溶酶原激活剂(t-PA)及其抑制物(PAI-I)。结果治疗前后及组间比较ACT均无显著变化,两组的t-PA活性治疗后均比治疗前明显增高,而PAI活性明显降低(均P<0.05或<0.01),组间比较,缬纱坦组t-PA活性升高及PAI活性降低的幅度显著高于对照组(P<0.01)。结论缬纱坦对急性冠状动脉综合征患者的凝血系统无明显影响,但可使t-PA活性增高而PAI-I活性降低。

Objective To investigate the effects of valsartan on coagulative and fibrinolytic system, Methods Sixty patients with acute coronary syndrome were randomly divided into control group （ n = 30 ） and valsartan group （ n = 30 ）. The control group received routine treatment, and the valsarton group were treated with routine therapy plus valsartan so per day. Blood samples were drawn at the moment of admission and the 3rd day after admission, respectively. Activated coagnlative time （ ACT）, tissue type plasminogen activator（ t - PA） and plasminogen activator inhibitor - I（ PAI - I） were measured. Results No significant changes of ACT had been found in both groups either before or after treatmeat, After treatment, the activity of t - PA significantly increased in both groups,while the activity of PAI- I significantly decreased （ P 〈 0.05 or P 〈 0.01 ）. Much more significant changes had been found in valsartan group than in control group. Conclusion Valsartan has no significant effect to coagulative system in patients with acute coronary syndrome while it can increase the activity of t - PA and decrease the activity of PAI- I.