依那普利对血压正常的非ST段抬高型心肌梗死患者血浆纤维蛋白原D-二聚体的影响

Effect of Enalapril on Plasma Fibrinogen FIB and D-dimer of Patients with non-ST-segment Elevation Myocardial Infarction

目的:探讨依那普利对血压正常的非ST段抬高型心肌梗死患者血浆纤维蛋白原(FIB)、D-二聚体的影响。方法:选择血压正常的非ST段抬高型心肌梗死患者89例,按随机单盲的原则分为常规治疗组(44例)和依那普利组(45例):常规治疗组予以抗凝、抗栓等药物治疗;依那普利组在常规治疗的基础上加用依那普利5mg/d口服。两组在治疗前和治疗后第1周、2周、4周、6周分别进行血浆FIB、D-二聚体的测定。结果:治疗后依那普利组FIB、D-二聚体水平在第1周、2周时分别为(8.47±0.87)g/L、(0.95±0.11)mg/L;(7.98±0.89)g/L、(0.92±0.11)mg/L。常规治疗组FIB、D-二聚体水平在第1周、2周时分别为(8.45±0.89)g/L、(0.93±0.11)mg/L;(8.26±0.89)g/L、(0.89±0.11)mg/L。两组比较差异无统计学意义(P>0.05)。至第4周时,依那普利组FIB、D-二聚体水平分别为(6.55±0.98)g/L、(0.76±0.08)mg/L,明显低于常规治疗组(7.20±0.79)g/L、(0.85±0.11)mg/L,差异具有统计学意义(P<0.01)。结论:依那普利具有降低心肌梗死患者血浆FIB、D-二聚体的作用,其机理可能与改善心肌梗死后凝血-纤溶系统功能有关。

Objective： To explore the influence of enalapril on FIB and D-dimer levels of patients with non-ST-segment elevation myocardial infarction（ NSTEMI）. Method： 89 patients,whose blood pressure was normal,were divided randomly into the normal treatment group（ 44 cases） and enalapril group（ 45 cases）. The normal group received anticoagulation drug therapy,and enalapril 5mg enalapril orally twice a day respectively. The plasma fibrinogen FIB and D-dimer levels of patients in two groups were detected before treatment and at first,second,forth and sixth weeks after treatment. Result： At first,second week after treatment,The plasma fibrinogen FIB and D-dimer levels of patients in enalapril group was（ 8.47±0.87） /L,（0.95±0.11） mg/L;（7.98±0.89） g/L,（0.92±0.11） mg/L.While those levels in normal treatment group was（8.45±0.89） g/L,（0.93±0.11） mg/L;（8.26±0.89） g/L,（0.89±0.11） mg/L respectively.There＇s insignificant difference between them（ P〉0.05）.At forth week after treatment,The plasma fibrinogen FIB and D-dimer levels of patients in enalapril group and normal treatment group was（ 6.55±0.98 g /L,0.76±0.08 mg /L）and（ 7.20±0.79 g /L,0.85±0.11 mg /L）,respectively.There＇s significant difference between them（ P〈0.01）.Conclusion： It can decrease the levels of FIB and D-dimer in patients with NSTEMI,The mechanism may relate with blood coagulation and fibrinolysis after improving the situation of myocardial infarction.