血浆凝血因子Ⅶ测定在冠心病中的临床意义

Detection of plasma coagulation factor Ⅶ in patients with coronary heart diseases and its clinical significance

目的 :检测冠心病患者血浆中活化因子 ( F a)、因子 相关抗原 ( F ∶ Ag)与因子 活性 ( F ∶C) ,探讨其临床意义。方法 :F a采用重组可溶性组织因子法 ,F ∶ Ag采用 EL ISA法 ,F ∶ C采用一期法测定。结果 :稳定型心绞痛组 ( 30例 )、不稳定型心绞痛组 ( 2 0例 )、急性心肌梗死 ( AMI)组 ( 2 0例 ) F a测定结果分别为 ( 2 .6± 0 .8) μg/L、( 2 .8± 0 .9) μg/L 与 ( 2 .9± 0 .9) μg/L,均较对照组 ( 40例 ) ( 2 .2± 0 .7) μg/L 为高 ( P <0 .0 5 )。三组中 F a/F ∶ Ag分别为 3.2 0、3.88与 3.81,均较对照组 ( 2 .6 0 )为高 ( P <0 .0 5 ) ,三组中的 F ∶ C仅稳定型心绞痛组增高 ( P <0 .0 5 ) ,不稳定型心绞痛组降低 ( P <0 .0 5 ) ,AMI组正常 ,而 F ∶ Ag仅稳定型心绞痛组降低 ( P <0 .0 5 ) ,其他组无明显改变。结论 :检测 F 评估冠心病及其危险事件的发生 ,以 F a、F ∶ Ag与 F ∶ C三项同时测定为好 ,而且用 F a绝对值及 F a/F ∶ Ag相对值作为高凝状态与危险因子比单测 F ∶

Objective:To detect plasma level of FⅦa,FⅦ∶Ag and FⅦ∶C in patients with coronary disease and discuss its clinical significance.Method:FⅦa was detected with recombinant factor method. FⅦ∶Ag was detected with ELLSA method. Phase I coagulation method was used to detect FⅦ∶C.Result:FⅦa levels were respectively ( 2.6 ± 0.8 ),( 2.8 ± 0.9 ),( 2.9 ± 0.9 ) μg/L in patients with stable angina (n=30),unstable angina (n=20) and acute myocardial infarction (n=20),all of which were significantly (P< 0.05 ) higher than those of controls (n=40) ( 2.2 ± 0.7 ) μg/L. FⅦa/FⅦ∶Ag values were separately 3.20 , 3.88 ,and 3.81 . All were significantly higher than those of controls ( 2.60 ) (P< 0.05 ). FⅦ coagulation activity rose up in patients with stable angina (P< 0.05 ),fell down in patients with unstable angina (P< 0.05 ) and remained normal in patients with AMI. Whereas FⅦ antigen level only decreased in patients with stable angina (P< 0.05 ),remained unchanged in the other 2 groups.Conclusion:Formerly,it is thought that increase of FⅦ∶C was a risk factor of coronary disease and AMI. But,the results of this study showed that patients with coronary heart diseases didn′t always have higher FⅦ∶C levels,but usually had increased FⅦa,FⅦa/FⅦ∶Ag levels. So we concluded that,to evaluate the risk factors of coronary artery disease,it was necessary to detect FⅦa,FⅦ∶Ag,FⅦ∶C simultaneously.Using FⅦa absolute value and FⅦa/FⅦ∶Ag value to represent hypercoagulatory state and risk factors was more reliable than determining Ⅶ∶C alone.