急性冠脉综合征患者血浆中凝血酶激活的纤溶抑制物变化

The Changes of Thrombin Activatable Fibrinolysis Inhibitor in Patients with Acute Coronary Syndrome

目的探讨急性冠脉综合征(ACS)患者血浆中TAFI:Ag和TAFI:A含量的变化。方法分别应用ELISA法、发色底物法测定40例冠状动脉造影(CAG)正常者和60例经CAG证实的ACS患者血浆中TAFI:Ag、TAFI:A含量;并对该两组TAFI:Ag和TAFI:A含量进行对照分析。结果 ACS患者血浆中TAFI:Ag均值为95±34%,TAFI:A均值为29.2±11.2μg/ml,且均明显高于CAG正常者(P<0.001)。亚组分析显示心肌梗死组中TAFI:Ag含量略高于心绞痛组但差异不明显(P>0.05),而TAFI:A含量则明显较高(P<0.05)。结论 ACS患者血浆中TAFI:Ag和TAFI:A均显著增高,表明TAFI在ACS发病过程中起一定作用;TAFI:Ag在心绞痛和心肌梗死中的表达可能是一致的,但在心肌梗死患者中TAFI:Ag的激活程度却明显加强,提示心肌梗死患者发病过程中存在较明显的纤溶功能抑制。

Objective To discuss the changes of the plasma thrombin activatable fibrinolysis inhibiton（TAFI：Ag and TAFI：A） levels in patients with acute coronary syndrome（ACS）.Methods There are 40 healthy adults as controls and 60 ACS patients in the study,all of the people were approved by coronary angiography（CAG）.The plasma levels of TAFI：Ag and TAFI：A were examined respectively with enzyme linked immunoadsordent assay（ELISA） or chrimato-substrate assay（CSA）,then to compare the results between controls and patients.Results The mean of the plasma TAFI：Ag and TAFI：A for ACS patients is 95±34% and 29.2±11.2 μg/ml,and both of these variances are significant as compared with the controls（P0.001）;the level of plasma TAFI：Ag in myocardiac inparction（MI） group is little higher than that of the unstable angina（UA） group,there is no significant,but the result of plasma TAFI：A is obviously statistical significance（P0.05）.Conclusion There is a higher level of plasma TAFI in ACS patients as compared with the controls;The result indicates that TAFI play a role in the procession of ACS.The genetic expression of TAFI：Ag in UA may be the same as that in MI,but the activation of TAFI：Ag is obviously enhanced,and this demonstrates that there may be a fibrinolytic inhibition in procession of MI.