冠心病患者抗凝与纤溶功能的改变及其临床意义

Changes and clinical significance of antithrombin and fibrinolysis in patients with coronary heart disease

目的:探讨冠心病患者凝血、抗凝与纤溶功能的改变及临床意义。方法:应用发色底物法及胶乳增强的免疫比浊法分别测定不同类型的冠心病患者160例及健康对照者80例血浆抗凝血酶(AT)、组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活抑制物-1(PAI-1)及D-二聚体(D-dimer)的活性或含量水平,并进行比较分析。结果:与对照组比较,冠心病患者AT、t-PA的活性显著降低,PAI-1、D-dimer的活性或含量水平显著增高(P<0.05或P<0.01);与稳定性心绞痛患者组比较,不稳定性心绞痛组及心肌梗死组AT、t-PA、PAI-1、D-dimer的活性或含量水平亦有显著性改变(P<0.05或P<0.01)。结论:冠心病患者特别是不稳定性心绞痛及心肌梗死患者存在高凝状态及纤溶活性亢进。

Objective：To investigate the changes of antithrombin and fibrinolysis in patients with coronary heart disease（CHD）and its clinical significance.Method：Antithrombin（AT）,tissue type plasminogen activator（t-PA）,plasminogen activator inhibitor-1（PAI-1）and D-dimer were tested by chromogenic substrate assay and latex enhanced immunoturbidimetry assay in 160 cases with coronary heart disease（including 65 cases of stable angina pectoris,52 unstable angina pectoris and 43 acute myocardial infarction）and 80 health adults（control group）.Result：The activities of AT and t-PA were significantly lowered and PAI-1 and D-dimer were significantly increased in CHD group than those of control group（P〈0.05 or P〈0.01）.The changes of AT,t-PA,PAI-1 and D-dimer activity or concentration in UAP and AMI group had significant significance compared with SAP group（P〈0.05 or P〈0.01）.Conclusion：There might be hypercoagulation and hyperfibrinolysis state in CHD especially in UAP and AMI patients.