急性心肌梗塞溶栓治疗期间血浆D-二聚体的动态变化及其临床意义

目的 :探讨血浆 D-二聚体对评价溶栓治疗急性心肌梗塞 (AMI)的价值及意义。　　方法 :2 9例 AMI患者分为溶栓组 (n=2 1) ,未溶栓组 (n=8) ;溶栓组根据溶栓治疗后冠状动脉 (冠脉 )是否开通又分为溶栓再通组 (n=12 ) ,溶栓未通组 (n=9) ;采用酶联免疫吸附试验 (EL ISA)法检测血浆 D-二聚体的水平 ,并与正常对照组 (n=2 0 )进行比较。　　结果 :AMI未溶栓组血浆 D-二聚体较正常对照组显著升高 (P<0 .0 5 ) ;溶栓组血浆 D-二聚体较未溶栓组显著升高(P<0 .0 5 ) ,溶栓后血浆 D-二聚体较溶栓前显著升高 (P<0 .0 1) ,于溶栓后 6小时达高峰 ;溶栓再通组血浆 D-二聚体较溶栓未通组显著升高 ,溶栓前及溶栓后 6小时两组比较有极显著统计学意义 (P<0 .0 1)。　　结论 :AMI早期已有纤溶系统亢进 ,应用溶栓药后进一步激活纤溶系统而发挥作用 ,且以溶栓再通组更显著。

The Clinical Significance and Dynamic Change of Plasma D-Dimer during Thrombolysis in Patients with Acute Myocardial Infarction

Objective:To explore the significance of D dimer(d d) evaluating thrombolytic effects in patients with acute myocardial infarction(AMI). Methods:Twenty nine patients with AMI were devided thrombolytic group( n =21)and unthrombolytic group ( n =8).Thrombolytic group were devided reperfusion and nonreperfusion group.Plasma levels of d d were measured by a sanwich ELISA assay,and compaired with 20 healthy subjects. Results:Plasma d d of AMI was remarkably higher than those of normal group;Plasma d d of thrombolytic group was remarkably higher than nonthrombolytic group.Plasma d d after thrombolytic therapy was remarkably higher than that before thrombolytic therapy.Plasma d d of reperfusion group was higher than nonreperfusion group. Conclusion:Fibrinolytic system activation occured in early period in patients with AMI and fibrinolytic system was further activated after given urokinase.This change is more obvious in reperfusion group.