冠心病介入治疗后t-PA和PAI及vWF:Ag活性变化

Study on Relationship Between Changes of Fibrinolytic Activity and Prognosis after Successful PTCA

目的 对46例经皮腔内冠状动脉成形术(PTCA)成功患者进行6个月随访,通过t-PA活性(t-PA:A)、PAI活性(PAIs:A)、vW因子抗原(vWF:Ag)的检测以观察内皮细胞纤溶活力变化和患者预后的关系。方法 根据冠状动脉造影结果将患者分为无再狭窄组35例和再狭窄组11例。所有患者均在PTCA术前及术后1h、1月、3月、6月肘静脉抽血,检测t-PA:A、PAIs:A和vWF:Ag含量。 结果 再狭窄组血浆t-PA:A术后上升,随访中下降;PAIs:A呈上升趋势,无再狭窄组血浆t-PA:A水平在术后1h上升,且在以后随访中仍保持上升趋势,其PAIs:A逐步下降(P<0.05);二组相比,再狭窄组PAIs:A水平在术后3个月和6个月时分别比无再狭窄组增高48％和66％(P均<0.05)。vWF:Ag水平,无再狭窄组术后恢复至术前水平,而再狭窄组术后始终比术前增高。 结论 异常增高的PAIs:A及vWF:Ag水平对血管成形术后再狭窄,可能起重要作用。

Objective To analyse possible association between changes of fibrinolytic activity and restenosis after successful percutaneous transluminal coronary angioplasty (PTCA). Methods Forty-six patients with coronary heart disease undergoing PTCA were followed up with angiography during 6 months, and were devided into no-restenosis group(A) and restenosis group(B). The plasma t-PA : A, PAIs : A, and vWF; Ag levels of all patients were determined before PTCA and Ih, 1m, 3m, 6m after PTCA. Results The difference in plasma t-PA : A levels before and after PTCA between group A and B was not significant. The levels of plasma PAIs : A in group B at 3m, 6m after PTCA were higher than those in group A(P <0. 05). The levels of vWF : Ag at Ih after PTCA were increased in both groups, but were decreased in 6-month follow-up in group A,yet were still higher in group B than those in group A(P <0. 05). Conclusion The results indicate that abnormality of PAIs activity and vWF ? Ag may play an important role in restenosis after successful PTCA.