冠状动脉介入治疗患者tPA、D-二聚体、FDP检测的临床应用

Clinical Application of the tPA,D-D,FDP Before and After PCI in Patients with CHD

目的:动态观察冠心病患者冠状动脉介入(PCI)治疗前后血浆组织纤溶酶原激活物(tPA)、D-二聚体(D-D)、纤维蛋白(原)降解产物(FDP)含量。方法:用ELISA对60例冠心病患者PCI术前、术后即刻和术后5天以及40例非手术对照组上述指标进行检测和比较;并进行门诊随访分析。结果:冠心病患者术前tPA含量明显低于对照组(P<0.05),D-D、FDP含量明显高于对照组(P<0.05);PCI术后即刻tPA较术前明显降低(P<0.01),术后5天回升至术前水平,但仍比对照组明显降低(P<0.01);D-D、FDP含量术后即刻较术前明显升高(P<0.01),术后5天下降至与术前无明显差异,但仍高于对照组(P<0.01)。门诊随访31例PCI术后疗效稳定患者tPA、D-D、FDP均与对照组无显著性差异(P>0.05)。结论:PCI可能造成冠心病患者血管内膜损伤而导致机体纤溶功能短期降低。

Objective:To minitor the dynamic change of tissue type plasminogen activator(t-PA),D-dimer(D-D),fibrinogen degradation product(FDB) after and before PCI in patients with CHD.Method:tPA,D-D and FDP were measured before and after PCI at 0,5 days in 60 patients with CHD by ELISA.Analysis by follow up visit in out-patient-clinic.Results:The concentration of t-PA was obviously lower than the control(P<0.01),the levels of D-D and FDP were obviously higher than the control(P<0.01);The t-PA acitivity was obviously low before and after PCI in patients with CHD,and began to rise gradually after PCI 5 days,but it was still lower than the control(P<0.01).The levels of D-D and FDP were obviously degrade after PCI 5 days,but it was still higher than the control(P<0.01).However,there was no significance in the levels of tPA,D-D and FDP between the 31 follow up visit cases and the control.Conclusion:The plasma fibrinolyolytic function is significantly lower in patients with CHD than that before PCI.The level of plasma fibrinolytic function is related to restenosis after PCI.