尿激酶治疗冠心病血浆D-二聚体的变化研究

The changes of plasma D-dimer in urokinase treatment for coronary artery disease

应用ELISA双抗体夹心法，检测了31例冠心病患者血浆D-二聚体的含量。冠心病中急性心肌梗死（AMI）9例，不稳定型心绞痛（UAP）22例。结果：AMI及UAP患者血浆D-二聚体含量均高于对照组（P＜0．01），且AMI组高于UAP组（P＜0．05）。应用尿激酶治疗后，AMI组中血浆D-二聚体含量又再度升高（P＜0．01），以溶栓后6h升高最为显著。而UAP组1周内均无明显改变（P＞0．05）。提示：①AMI及UAP的交联纤维蛋白D-二聚体增多有血栓的形成和溶解；②AMI患者应用尿激酶溶栓治疗后，血浆D-二聚体再度升高，可为溶栓成功的指标之一，而小剂量尿激酶治疗UAP后，D-二聚体无明显变化。

In 31 cases of coronary heart disease,plasma rrdimer concentration was measured by ELISA double-layered antibody method. 9 patients with acute myocardial infarction (AMI) and 22 with unstable angina pectoris (UAP). The levels of plasma ixdimer were higher in the AMI and UAP cases than those in controls group (n= 57) (P<0.01) and plasma D-dimer was higher in AMI group than UAP group (P<0. 05). After urokinase (UK) treatment, the plasma D-dimer increased further (P<0. 01 ) and reached the peak in 6 hours after thrombolytic therapy. But in UAP group, there was no significant difference on plasma D-dimer within 1 week after UK treatment. The result suggested that: ① Higher level of plasma ixdimer may suggest that thrombogenesis and thrombolysis occur.②Further increased plasma rrdimer couled serve as one indicator of successfuI thrommbolytic therapy' But rrdimer had no obvious changes in UAP patients with small dose of UK treatment.