磁化支架安置术后血浆纤溶活性变化及临床意义

Influences of intracoronary magnetic stents on coronary sinus fibrinolysis activities in patients with coronary artery diseases

目的 :观察冠心病患者冠状动脉内支架安置术 (ICS)后冠状窦血浆组织型纤溶酶原激活物 (t- PA)和纤溶酶原激活物抑制剂 - 1(PAI- 1)活性的动态变化 ,探讨磁化支架对术后再狭窄防治的作用机制。方法 :冠心病患者 38例 ,随机安置普通支架 18例 (I组 ) ,磁化支架 2 0例 (II组 ) ,分别于 PTCA前、ICS后即刻、6 h时自冠状窦采血来检测血浆 t- PA和 PAI- 1的活性。结果 :两组患者的 t- PA活性在术后即刻均降低 ,而术后 6 h II组的 t- PA活性较之 I组有明显恢复 (P<0 .0 5 )。相反 ,术后即刻两组患者的 PAI- 1活性均明显升高 (P<0 .0 1) ;然而 ,在术后 6 h,II组的 PAI- 1活性已恢复到术前水平 (P<0 .0 5 )。结论 :磁化支架可有效促进冠脉循环纤溶活性的恢复 ,可能对再狭窄有防治作用。

AIM: To investigate the effects of intracoronary magnetic stents on plasma tissue type plasminogen activator (t PA) and plasminogen activator inhibitor 1(PAI 1)activities. METHODS: Non magnetic stents(NMS, n =18) and magnetic stents (MS, n =20) were randomly implanted in 38 consecutive patients with coronary artery diseases .Blood was drawed from coronary sinus to measure fibrinolysis activity.RESULTS: The t PA activities in the two groups were lowered immediately after stenting. However, the t PA activity in MS group almost was increased to the baseline level at 6 h, compaired with that of NMS group ( P <0.05).On the contrary, the PAI 1 activities in both of the groups were markedly elevated immediately after stenting( P <0 01). Nevertheless,the one in MS group was restored to the pre PTCA level at 6 h . CONCLUSION:Intracoronary magnetic stents may be beneficial to restoration of fibrinolysis activity in coronary sinus plasm after angioplasty, which can be helpful in preventing restenosis.