急性冠脉综合征患者纤溶活性和血小板活性的相关性研究

Study on Correlation between Fibrinolytic Activity and the Activity of Platelet in Patients with Acute Coronary Syndrome

目的 :探讨急性冠脉综合征 (ACS)患者纤溶活性及血小板活性的动态变化规律及其相关性。方法 :选择49例非溶栓的ACS患者及32例正常对照组。分别于发病后1 ,2 ,3 ,7 ,14d采集静脉血样 ,用发色底物法检测组织纤溶酶原激活剂 (tPA)及组织纤溶酶原激活剂抑制剂_1(PAI_1)的活性 ,同时用酶联免疫吸附法测量血小板膜糖蛋白GPIIb、IIIa的含量。结果 :ACS患者中tPA活性较对照组明显减少 ,PAI_1则明显升高 (P<0 .01) ;血小板GPIIb、IIIa含量较对照组明显得升高 (P<0 .01)。ACS组的tPA活性与PAI_1活性呈负相关 (r= -0 .6607 ,t=2 .807 ,P<0 .01) ;血浆PAI_1活性与GPIIb、GPIIa呈显著正相关 (r=0 .6901 ,t=3 .013、0 .7121 ,t=3 .195,均P<0 .01)。结论 :tPA、PAI_1、GPIIb。

Objective:To investigate the serial changes of fibrinolytic activity and the activity of platelet in patients with acute coronary syndrome(ACS)and its correlation.Methods:Forty-nine patients with ACS without thrombocytolysis treatment were selected and32normal subjects were as controls.Venous blood samples were obtained immediately before administration,1d,7d,and14d after the administration.Plasma levels of tissue plasminogen activator(tPA)and its inhibitor(PAI-1)activities were determined by spectrophotemetometric as-say,and plasma concentrations of platelet glycoprotein IIb and IIIa(GPIIb,IIIa)were measured by en-zymelinked immunosorbent assay(ELISA).Results:The levels of tPA activity in ACS group were significantly lower than those in normal group(P<0.01),the changes of PAⅠ-1activity were significantly higher than those in normal group(P<0.01).Plasma concentrations of GPIIb,IIIa in ACS group were significantly higher than those in normal group(P<0.01).In ACS group,PAⅠ-1activity negatively correlated with tPA activity(P<0.01),and positively correlated with concentrations of GPIIb and GPIIIa(P<0.01).Conclusion:The val-ue of tPA,PAⅠ-1,GPIIb,and GPIIIa are important in diagnosis and therapy for patients with ACS.