介入封堵术对成人先天性心脏病患者血浆t-PA和PAI-1水平的影响

Effects of transcatheter closure on plasma tissue plasminogen activator and plasminogen activator inhibitor-1 in adult patients with congenital heart disease

目的:评价介入封堵术对成人先天性心脏病(CHD)患者血浆组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制物-1(PAI-1)水平的影响。方法:采用酶联免疫吸附法检测70例CHD患者及30例健康人(正常对照组)血浆t-PA、PAI-1水平。所有CHD患者分别于介入封堵术前头天,术后24h,1、3、6、12个月检测血浆t-PA、PAI-1水平。结果:介入封堵术前,CHD患者血浆t-PA、PAI-1水平比正常对照组明显增高(P<0.01)。介入封堵术后1个月,CHD组血浆PAI-1水平开始逐渐下降,术后6个月恢复正常水平;血浆t-PA水平在术后1个月升高,术后3个月始下降,术后6个月恢复正常水平。结论:介入封堵术可通过改变血浆t-PA、PAI-1水平而改善成人CHD患者的内源性纤溶功能。

Objective：To evaluate the effects of transcatheter closure on plasma tissue plasminogen activator （t- PA） and plasminogen activator inhibitor-1 （PAI-1） in adult patients with congenital heart disease （CHD）. Method： The levels of plasma t-PA and PAI-1 were detected in 70 patients with CHD （CHD group） and in 30 normal controls （NC group） by enzyme-linked immunosorbent assay （ELISA）. The levels of plasma t-PA and PAI-1 in patients were detected one day before transcatheter closure and 24 hours, 1 month, 3 months, 6 months, 12 months after transcatheter closure. Result：Compared with the normal controls, the levels of plasma t-PA and PAI-1 in patients with CHD were significantly increased （P〈0.01）. The level of plasma PAI-1 began to decrease at 1 month after transcatheter closure, and it was near the normal level at 6 months. The level of plasma t-PA began to increase at 1 month after transcatheter closure, while decreasing at 3 months, and it was near the normal level at 6 months. Conclusion：Transcatheter closure can improve fibrinolytic function of adult patients with CHD by changing the levels of plasma t-PA and PAI-1.