急性冠脉综合征患者不同时点组织因子检测的临床价值

目的探讨血浆组织因子抗原(TF:Ag)含量在老年急性冠脉综合征(ACS)患者发生、发展中的动态变化的临床意义。方法采用ELISA方法测定81例老年ACS患者不同分型和稳定心绞痛(SAP)及健康老年体检者(对照组)血浆中的TF水平。结果急性心肌梗死组(AMI,36例)和不稳定心绞痛组(UAP,45例)急性发作时TF含量明显高于稳定心绞痛组(SAP,38例)和正常对照组50例(P<0.01)。监测TF含量变化,其AMI组和UAP组治疗后第1周、第3周与SAP组和正常对照组比较仍有显著性差异(P<0.01);至第3月、第6月AMI和UAP组TF含量下降较明显,虽仍高于SAP和对照组,但比较未显示有差异(P>0.05);不管是AMI组还是UAP组第3月、第6个月TF含量与急性发作期、发作后1周、3周比较均下降明显,有显著性差异(P<0.05)。分别对AMI和UAP组不同时间点TF含量动态观察并进行分析后发现,在ACS发生后3月,TF含量下降仍不明显者与伴有诸多心血管疾病危险因素有关。结论对ACS患者进行不同时间点的TF检测,可作为临床判定预后的参考。

The Clinical Value of Tissue factor Determined in the Patients with Acute Coronary Syndrome at Different Time

Objective Evaluate plasma levels of the tissue factor in the patients with acute coronary syndrome （ACS）. Methods Plasma levels of the TF were determined in 81 eldly patients with ACS and sta- ble angina pectoris （SA） and controls by ELISA methods. Results Acute myocardial infarction group （AMI, 36 cases） and unstable angina pectoris （UAP, 45 ） during acute attack of TF were significantly higher than those in stable angina group （SAP,38 cases） and 50 cases of normal control group （P 〈 0.01）. The TF concentration on week 1 , week 3 after treatment showed continue to higher both in patients with AMI （P 〈 O. 01 ） and UA（ P 〈0.01 ） compared to SA and normal subjects. The plasma levels of TF on month 3, month 6 after AMI and UA began to become significantly decrease than before. However compared to the patients with SA and normal subjects, The TF concentration in patients with AMI and UA showered higher , but nonsignifi- cantence （P 〉 0.05 ）. There was a significant trend to decreaser plasma levels of TF in patients with AMI and UA on month 3, month 6 after treatment in contrast to the TF levels on acute phase, week 1 to week 3 （P 〈 O. 05 ）. Dynamic observation and analyztion the characteristics of plasma levels of TF in patients with UA and AMI respectively. It was proposed that the TF concentration on month 3 after ACS showed only slightly, but non-signifiantly decreaser are suggested to be associated with the high-risk factor in coronary heart disease. Conclusion Dynamic observation the plasma level of TF in patients with ACS may be play a pivotl role in prediction prognosis .