急性心肌梗塞溶栓治疗前后纤溶系统的动态观察

A Dynamic Observation of plasma Fibrinolytic system in patients with acute myocardial infarction before and after Thrombolytic Therapy

对37例急性心肌梗塞(AMI)患者在溶栓治疗中对其血中血浆D—二聚体(DD)水平,纤溶酶原激活物(PA)及其抑制物(PAI)活性,进行动态观察。并分析其与梗塞相关冠脉(IRA)再通的关系,结果表明:AMI组与正常组相比,血浆DD水平显著升高(P<0.01),血浆PA:A无变化,PAI:A显著升高(P<0.01);溶栓治疗后,上述指标较溶栓前差异非常显著(P<0.001);溶栓后IRA未通组与再通组相比,溶栓后6小时、24小时PAI:A前者较后者显著升高(P<0.05),PA:A及DD水平无显著差异(P>0.05)。提示PAI在AMI血栓形成中具有重要的病理意义。

Plasminogen activator(PA) ,Plasminogen activator inhibitor(PAI) and plasma D- dimer level were determined in 37 patients with acute myocardial infarction(AMI) More, and after thrombolytic therapy. The results showed that there was no diference of PA: A between patients with AMI and normal controls, whereas PA I activity and plasma DD level were much higher in patients with AMI; in patients treated with thrombolysis, devalues of these three parameters of coagulation before treatment were significantly different from that of parameter after treatment, morever it was much higher of PAI activiy in IRA occlution group than the one in IRA patency group 6 and 24 hours after thrombolysis. In conclution, this study suggest that PAI could play an important role in thrombosis and it s great rebounding after thrombolysis might be due to some of coronary arterial thrombi being resistant to lysis.