不稳定型心绞痛患者冠脉循环中凝血纤溶的变化

The Changes of Coagulation and Fibrinolysis in Coronary Circulation of Patients with Unstable Angina Pectoris

目的:了解不稳定型心绞痛(UAP)患者冠脉循环中凝血纤溶的变化。方法:选22例UAP患者和10例经冠脉造影证实冠状动脉无狭窄的患者为研究对象。采集冠状静脉窦(CS)、主动脉根部(AO)和上腔静脉(SVC)血,测定组织型纤溶酶原激活剂(t-PA)和纤溶酶原激活剂抑制剂(PAI)活性、D-二聚体(DD)及纤维蛋白原(Fg)含量。结果:与对照组相比,UAP患者冠脉循环中t-PA活性减低(P<0.05),PAI活性增高(P<0.01),Fg含量增高(P<0.01),DD含量增高但无统计学意义(P>0.05)。UAP患者三部位各指标测定结果无明显差异(P>0.05)。结论:UAP患者存在凝血、纤溶功能的失调,UAP患者纤溶活性降低,凝血功能增强;UAP患者在心绞痛缓解后,冠脉循环中凝血、纤溶状态与周围循环血中一致。

Objective： To assess the changes of coagulation and fibrinolysis in coronary circulation of patients with unstable angina pectoris（UAP）. Methods： 22 UAP patients and 10 control subjects with arteriographically normal coronary arteries were collected, plasma t - PA and PAI activity, plasma concentration of DD and Fg were measured. Results ： Compared with the control group, the patients with UAP had a significant （ P 〈 0.05） decrease in plasma t - PA activity, and a marked （ P 〈 0.01 ） increase in PAI activity ; The plasma concentration of Fg in CS was elevated （ P 〈0.01 ） ; The levels of DD in CS were a little higher than those of the control subjects, but had no statistical significance （ P 〉 0.05）. All these profiles did not differ in CS, AO, and SVC of either the UApipatients or the control subjects. Conclusion：The results of the study demonstrate a prolonged ac- tivation of coagulation and impairment of the fibrinolysis in patients with unstable angina pectoris. After acute phase, the state of coagulation and fibrinolysis in coronary circulation of UAP patients is similar to that in peripheral blood.