急性心肌缺血时冠状窦血浆纤维蛋白原的改变及意义

The change and significance of local plasma fibrinogen during acute myocardial ischemia

通常人们认为,急性心肌缺血可引起血浆纤维蛋白原(Fg)的增高;但是在缺血区局部Fg的变化并不清楚。本文在17条犬上,以自制微米缩窄器造成冠脉左旋支狭窄与梗塞,观察了冠状窦Fg和血小板数(PC)的改变。结果表明:当冠脉狭窄大于75%后,急性心肌缺血可引起Fg含量的减少,当冠脉大狭窄于90%后,PC也出现减少。病理组织学检查在狭窄部位有内皮细胞的损伤、血小板的粘附及冠状动脉血栓和微血栓的形成。这一结果提示:急性心肌缺血可引起血浆Fg的减少,Fg的减少与血小板的聚集及血栓的形成有关。

It is general belied that myocardial ischemia caused an increase of plasma fibrinogen(Fg),but the changes of Fg in ischemic region is not clear.In 17 open chest dogs, an external stenosis or infarction was produced by a micro-meter constrictor on left circumflex coronary artery. The changes of Fg and platelet count(PC) in coronary sinus were observed for 60 min. The results showed that acute myocardial ischemia produed a decrease in Fg when coronary artery stenosis was more than 75%; there was also a decrease in PC when stenosis was more than 90%. The reduced amplitude of PC was more than that of Fg. Histopathologic examination confirmed the presence of damanged endothelial cell, platelet adhesion and aggregation coronary thrombosis and microemboli in ischemic region It is suggested that acute myocardial ischemia lead to a decrease of Fg in the ischemic myocardium, which was associated with platelet aggregation and coronary thrombosis.