血浆纤溶活性测定在冠心病中的意义

Importance of fibrinolytic activity in patients with coronary artery diseases

目的 研究血浆纤溶活性与冠脉病变程度、范围及稳定性的关系。方法 根据受累冠脉数、狭窄程度及病变稳定性将 2 56例患者分别进行分组 ,测定并比较各组患者的组织型纤溶酶原激活物 (tissueplasminogenactivator,t-PA)及纤溶酶原激活物抑制剂 (plasminogenactivatorinhibitor- 1 ,PAI- 1 )血浆浓度。结果 ①不稳定型心绞痛组患者血浆PAI- 1活性高于稳定型心绞痛组患者 (1 3 64± 2 32vs 6 2 2± 1 78,P <0 0 1 ) ;②多支冠脉病变组患者血浆PAI - 1活性高于单支病变组患者(1 1 67± 2 1 2vs 6 38± 1 72 ,P <0 0 1 ) ;③堵塞组患者较狭窄组患者血浆PAI- 1活性显著升高 (1 2 69± 1 82vs 8 38± 1 82 ,P<0 0 1 ) ;④冠脉粥样病变的范围、程度及稳定性与血浆t-PA活性没有明显关系。结论 血浆PAI - 1活性对冠脉病变的范围。

Objective To study the correlation of fibrinolytic activity to the area,extent,and stability of coronary artery culprit lesion.Methods In 256 patients undergoing coronary angiography,tissue plasminogen activator(t-PA) & plasminogen activator inhibitor-1(PAI-1) were measured with usual procedures.Results ①There was a positive association between PAI-1 and unstable angina (13 64±2 32 vs 6 22±1 78, P <0 01);②A strong relationship between PAI-1 and the area and extent of coronary artery disease was found (11 67±2 12 vs 6 38±1 72 & 12 69±1 82 vs 8 38±1 82, P <0 01);③There was no relation between t-PA and the severity of coronary artery culprit lesion.Conclusion Elevated PAI-1 may predisposes to the area,extent and destabilization of culprit lesion in coronary artery.