心肌梗塞患者凝血及纤溶状态的研究

Study on coagulation and fibrinolysis in patients with myocardial infarction

目的 :为研究心肌梗塞 (MI)患者 [包括急性心肌梗塞 (AMI)及陈旧性心肌梗塞 (OMI) ]凝血及纤溶状态与冠脉血栓形成的关系。方法 :测定了 93例心肌梗塞患者 (其中 AMI46例 ,OMI47例 )及正常对照组 40例 ,心绞痛 45例的凝血、纤溶分子标记物及血栓弹力图并进行比较。结果 :MI组凝血指标及纤溶指标均高于正常对照组 (P<0 .0 5 )及心绞痛组 (P<0 .0 5 )。 OMI组凝血、纤溶指标均高于正常对照组及心绞痛组 (P<0 .0 5 ) ,而低于 AMI组 ;MI组其血栓弹力图 (TEG)的 r值及 k值较正常对照组及心绞痛组明显缩短 (P<0 .0 5 ) ,但 AMI组与 OMI组之间无差异性。结论 :MI的发病机制与冠脉血栓形成密切相关 ,而 OMI患者也处于高凝状态 ,它是冠脉再栓的重要因素。

Objective:To study the relation between coronary thrombosis,and coagulation and fibrindysis in patients with myocardial infarction Method:Thrombin antithrombin Ⅲ comple(TAT),fibrin peptide A(FPA)、D D dimer、d2 pI and thromboelastograph(TEG) in MI(including AMI、OMI) patients were detected and the results were compared with patients with angina pectoris and normal control Result:the levels of TAT、FPA and D D dimer in MI were significantly higher than those in normal control(P<0 05) and those in OMI were lower than those in AMI(P<0 05) The r value and k value in MI was significantly higher than that in normal control(P<0 01) Conclusion:The results suggest that the coagulation activation and fibrin formation exist in the patients with MI