组织因子及其抑制物在急性冠脉综合征中的作用研究

The Effect of Tissue Factor and Tissue Factor Pathway Inhibitor in Acute Coronary Syndrome

探讨急性冠脉综合征发生中血浆组织因子 (TF)及其抑制物 (TFPI)含量的动态变化及其血管紧张素转换酶抑制剂 (ACEI)captopril干预治疗的作用。用ELISA方法检测急性心肌梗塞 (AMI)不稳定心绞痛(UA)患者入院后即刻、第 1天、2天、3天、1周、2周、3周不同时间点血浆TF及TFPI的含量。 1 50例AMI患者中 ,AMI用ACEI干预治疗 (AMI +ACEI组 ) 2 5例 ,常规治疗组 (AMI组 ) 2 5例 ,UA组 2 8例 ,血浆TF、TFPI水平均明显高于正常对照组 (P <0 0 0 1)。AMI+ACEI组血浆TF水平发病后第 3天开始下降 ,于 2周时间点明显下降 ,同AMI组及UA组比较有显著的差异 (P <0 0 0 1)而较对照组比较差异无显著性 (P >0 0 5) ,AMI +ACEI组TFPI含量无明显下降 ,持续稳定在较高水平。 2 TF与TFPI呈正相关 (P <0 .0 1) (r=0 549)。组织因子及其抑制物在急性冠脉综合征中起重要作用。ACEI药物降低血浆TF水平对TFPI无影响 。

The purpose of this investigation was to discover the plasma levels of TF and TFPI and their changing levels in acute coronary syndrome and to assess the efficacy of angiotansin converting enzyme inhibitor captopril in patients with acute myocardial infarction.The plasma levels of TF and TFPI were measured in patients suffered from acute myocardial infarction、unstable angina and control subjects on immediate time、the first、second、third day and first、second、third week after hospitalization.The plasma concentration was assayed With ELISA method.Results:(1)The plasma level of TF and TFPI in 50 patients with AMI including 25 cases who were treated with usual therapy、25 patients treated with captopril and in 28 patients with UA was higher than that in control group significantly( P <0.001).The plasma level of TF in patients with AMI who were treated with captopril was decreased on the third day after hospitalization and was decreased significantly on the second week( P <0 001)compared with usual therapy and was not significantly different with control group( P >0.05).However,the plasma level of TFPI in patients with AMI who were treated with captopril didn't change respectively and was in a steady high level.(2)TF level correlated positively to TFPI level( P <0.01,r=0.549).Conclusion:TF and TFPI play an important role in acute coronary syndrome.ACEI is able to decrease the plasma level of TF、TF/TFPI ratio.