摘要
Objectives To study the status of fibrinolytic inhibition in patients of acute coronary syndrome(ACS) complicated with type II diabetes mellitus (NIDDM) and to evaluate the effect of fibrinolytic inhibition to the clinical prognosis. Methods Type II diabetes mellitus was defined by ADA 1997/WHO 1998 criteria. The subjects were divided into treatment groups that included 39 patients of ACS with 20 cases of acute myocardiac infarction (AMI), 36 patients of ACS + NIDOM with 20 cases of AMI. Twenty cases of healthy people were randomized to control group. The plasma level of tissue type plas-minogen activator (t - PA), plasminogen activator inhibitor type - 1 (PAI - 1) and plasma D - dimer were detected by using elisa technique. The index of statue in fibrinolysis was detected with the plasma level of D -dimer and the rate of PAI - 1/D - dimer in percentage. This index was used to evaluate the fibrinolytic inhibition and the clinical outcome in all the patients with AMI in treatment groups. The clinical outcome in patients with AMI consisted of the rate of reperfusion, the incidences of re - infarction, severi-ous arrhythmia, pump failure and death in the early period of AMI. Results The plasma level of PAI - 1 and D - dimer was higher in the two treatment groups than that in the control group ( P < 0. 01). The plasma level of PAI - 1 significantly higher in ACS + NIDDM patients than that in ACS ( P < 0. 05), but the plasma level of D - dimer raised from basic level was significantly lower in ACS + NIDDM than that in ACS ( P < 0. 05) . The rate of PAI - 1 /D - dimer in percentage was significantly higher in ACS + NIDDM than that in ACS or in control group ( P < 0. 01). For AMI patients in two treatment groups, the rate of reperfusion after the thrombolytic therapy was significantly lower in ACS + NIDDM than that in ACS( P < 0. 01) . The rate of incidences in pump failure was significantly higher in ACS + NIDDM than that in ACS too ( P < 0. 05). The morbidity of severious arrhythmia, re - infarction and the mortality were also higher in ACS + NIDDM; however the difference was not significant (P<0. 05) . Conclusions The plasma level of D - dimer combined with the rate of PAI - 1 /D - dimer in percentage could be used to be the evidence and the index to evaluate the status of fibrinolytic inhibition in patients of ACS + NIDDM, and could be used to evaluate the effect of the fibrinolytic inhibition to the outcome of treatment and clinical prognosis in ACS patient.
Objectives To study the status of fibrinolytic inhibition in patients of acute coronary syndrome(ACS) complicated with type II diabetes mellitus (NIDDM) and to evaluate the effect of fibrinolytic inhibition to the clinical prognosis. Methods Type II diabetes mellitus was defined by ADA 1997/WHO 1998 criteria. The subjects were divided into treatment groups that included 39 patients of ACS with 20 cases of acute myocardiac infarction (AMI), 36 patients of ACS + NIDOM with 20 cases of AMI. Twenty cases of healthy people were randomized to control group. The plasma level of tissue type plas-minogen activator (t - PA), plasminogen activator inhibitor type - 1 (PAI - 1) and plasma D - dimer were detected by using elisa technique. The index of statue in fibrinolysis was detected with the plasma level of D -dimer and the rate of PAI - 1/D - dimer in percentage. This index was used to evaluate the fibrinolytic inhibition and the clinical outcome in all the patients with AMI in treatment groups. The clinical outcome in patients with AMI consisted of the rate of reperfusion, the incidences of re - infarction, severi-ous arrhythmia, pump failure and death in the early period of AMI. Results The plasma level of PAI - 1 and D - dimer was higher in the two treatment groups than that in the control group ( P < 0. 01). The plasma level of PAI - 1 significantly higher in ACS + NIDDM patients than that in ACS ( P < 0. 05), but the plasma level of D - dimer raised from basic level was significantly lower in ACS + NIDDM than that in ACS ( P < 0. 05) . The rate of PAI - 1 /D - dimer in percentage was significantly higher in ACS + NIDDM than that in ACS or in control group ( P < 0. 01). For AMI patients in two treatment groups, the rate of reperfusion after the thrombolytic therapy was significantly lower in ACS + NIDDM than that in ACS( P < 0. 01) . The rate of incidences in pump failure was significantly higher in ACS + NIDDM than that in ACS too ( P < 0. 05). The morbidity of severious arrhythmia, re - infarction and the mortality were also higher in ACS + NIDDM; however the difference was not significant (P<0. 05) . Conclusions The plasma level of D - dimer combined with the rate of PAI - 1 /D - dimer in percentage could be used to be the evidence and the index to evaluate the status of fibrinolytic inhibition in patients of ACS + NIDDM, and could be used to evaluate the effect of the fibrinolytic inhibition to the outcome of treatment and clinical prognosis in ACS patient.
