低分子肝素治疗不稳定性心绞痛时的血管性血友病因子变化及其临床意义

目的 :探讨低分子肝素 (clexane)治疗不稳定性心绞痛 (UAP)期间血浆血管性血友病因子 (vWF)含量的变化及其临床意义。方法 :选择入院前 2 4h内出现静息发作的不稳定性心绞痛患者 2 5例 (恶化劳累性心绞痛患者 10例、初发劳累性心绞痛患者 15例 ) ,入院后给予低分子肝素抗凝治疗 5d ,入院后即刻 (开始抗凝治疗前 )、48h、5d、14d(停止抗凝治疗后 9d)应用酶联免疫双抗体夹心法 (ELISA)测定血浆vWF含量的变化。正常对照组 2 0例。结果 :不稳定性心绞痛患者入院后各时刻血浆vWF含量均显著高于正常对照组 (P <0 0 1或P <0 0 5 ) ;Clexane抗凝治疗后 48h ,血浆vWF含量显著降低 (P <0 0 5 ) ,且持续至 14d无显著性改变 (P >0 0 5 )。结论 :增高的血浆vWF在不稳定性心绞痛的发生发展中起重要作用 ,低分子肝素 (clexane)抗凝治疗可显著降低不稳定性心绞痛患者急性期血浆vWF水平

Changes and clinical significance of plasma level of vWF in unstable angina pectoris treated with low molecular weight heparin

Objective: To explore changes and clinical significance of plasma level of vWF in unstable angina pectoris (UAP) treated with low molecular weight heparin (clexane).Methods: 25 patients with UAP were enrolled with the last episode of rest pain within the last 24 hours.All patients with UAP were treated for five days by clexane subcutaneously.Plasma level of vWF were measured in each patients on admission and 48 hours,7,14 days after anticoagulant treatment.20 healthy individuals were served as controls.Results: Plasma level of vWF was significantly higher at each moment in patients with UAP than in the controls ( P <0 05 or P <0 01).Plasma vWF level dropped significantly 48 hours after treatment with clexane ( P <0 05) and then remained no significant difference till 14 days after admission.Conclusion: Increase of plasma vWF level may play an important role in the development of UAP.Clexane can reduce vWF release significantly during the acute phase.