稳定性心绞痛与不稳定心绞痛高凝状态比较

Comparison of Hypercoagulable States in Patients with Stable Angina Pectoris and Unstable Angina Pectoris

通过检测反映高凝状态的分子标志物水平，研究稳定性心绞痛（ＳＡ）与不稳定心绞痛（ＵＡ）患者高凝状态的特点及临床意义。研究对象分为ＳＡ组（１５例）、ＵＡ组（２１例）及健康对照组（２０例）。与ＳＡ组或健康对照组比较，ＵＡ组血浆血小板颗粒膜蛋白水平升高（ＵＡ组、ＳＡ组与对照组分别为１３．２±６．０、８．０±６．６、３．３±１．６ｎｇ／ｍｌ，Ｐ＜０．０１），凝血酶原片段浓度增加（３组分别为１．３７±０．６１、０．５４±０．１１、０．４５±０．２３ｎｍｏｌ／Ｌ，Ｐ＜０．０５），血浆凝血酶抗凝血酶复合物、Ｄ－二聚体及尿纤维蛋白肽Ａ均明显升高（Ｐ＜０．０１），血浆α２抗纤溶酶降低。ＳＡ组与对照组比较，除血小板颗粒膜蛋白水平明显升高外（Ｐ＜０．０１），两组其他指标无显著差异。提示ＵＡ患者存在明显的高凝状态。认为高凝状态可能是ＵＡ某些临床特征的发生机制，ＵＡ与ＳＡ患者在某些指标水平上的差异有助于两者间的鉴别。

The alterations of hypercoagulable states in patients with stable angina pectoris (SA) and those with unstable angina pectoris (UA) were studied by detecting molecular markers representing hypercoagulability The sujects included 15 cases of SA, 21 cases of UA and 20 healthy controls Compared with SA group or the control group, the level of plasma platelet granule membrane protein (GMP 140) in UA group was increased (13 2±6 0 in UA group, 8 0±6 6 in SA group, and 3 3±1 6 ng/ml in control group, P <0 01) Concentration of prothrombin fragment was increased (1 37±0 61, 0 54±0 11, 0 45±0 23 nmol/L in UA, SA and control group respectively) Plasma levels of thrombin antithrombin complex,D dimer and urinal fibrinopeptide A in UA group were higher than those in SA group or the control Patients in UA group had low concentration of α 2 antiplamin with respect to individuals in SA group or the control group Except with high level of GMP 140, levels of other markers in SA group had no significant change as compared to the control The findings suggested patients with UA exhibited obvious activation of coagulation, thrombosis and secondary fibrinolysis The hypercoagulable state might be partial mechanism of clinical features in UA It was also believed that some markers might act as differential parameters of SA and UA