卡托普利对风湿性心脏病心房颤动患者血浆纤溶活性的影响

Effects of captopril on thrombolytic activity in patients with rheumatic heart disease and atrial fibrillation

目的：观察在风湿性心脏病伴心房颤动患者中卡托普利对血浆纤溶活性的作用。方法：将患者随机分组，即试验组３９例在常规治疗基础上加用卡托普利，对照组２１例按常规治疗；治疗前后分别留取血浆测定以下指标：组织型纤溶酶原激活物（ｔ－ＰＡ）活性、纤溶酶原激活物抑制物－１（ＰＡＩ－１）活性、纤溶酶原（Ｐｌｇ）活性、Ｄ－二聚体（Ｄ－ｄｉｍｅｒ）含量。结果：试验组组织型纤溶酶原激活物活性在卡托普利治疗７～１０天后显著性升高（Ｐ＜０．０５），纤溶酶原激活物抑制物－１活性显著性降低（Ｐ＜０．０１）；对照组在常规治疗后所有被检测的纤溶指标均无显著性改变。结论：卡托普利可能主要通过降低血浆纤溶酶原激活物抑制物－１活性而影响纤溶活性，提示卡托普利对防治此类患者动脉栓塞性并发症有益。

Effects of captopril on thrombolytic activity were studied in 39 patients with rheumatic heart disease and atrial fibrillation,and 21 same patients under routine treatment without captopril as control.It was found that captopril increased thrombolytic activity with increased activity of tissue plasminogenal activator(t-PA) and plasminogen,decreased activity of plasminogenal activator inhibitor-1(PAI-1)in plasma,and analysis of lineal relation between activities of t-PA and PAI-1 showed that the main reason of the changes of the above vauables might be the decrease of plasma activity of PAI-1.The results suggested that captopril be efficient for prevent such patients from arterial embolism.