心绞痛与急性心肌梗死患者血浆中组织因子途径抑制物的研究

目的:测定心绞痛(AP)与急性心肌梗死(AMI)患者血浆中组织因子途径抑制物(TFPI),并探讨其临床意义。方法:TFPI抗原(TFPI:Ag)测定采用双夹心ELISA抗原测定法,TFPI活性(TFPI:A)测定采用发色底物法。结果:AP与AMI各20例,TFPI:Ag与对照组比较均无差异(P>0.05),TF-PI:则明显升高,AMI患者升高比AP更显著,与对照组比较APP值<0.01,AMIP<0.001。AMI用链激酶(SK)溶栓治疗10例发现溶栓后TFPI:Ag与TFPI:A均有上调现象。结论:冠心病晚期因TFPI的消耗,TFPI:Ag的反馈性升高已不明显,但TFPI:A仍明呈代偿性增高。溶栓后TFPI上调,表明冠状动脉血流改善后,心肌动力作用明显地增强,对TFPI具有促进作用。

Study of Plasma Tissue Factor Pathway Inhibitor in Patients with Angina Pectoris or Acute Myocardial Infarction

To explore the clinical significance of tissue factor pathway inhibitor (TFPI) in patients with angina pectroris (AP) or acute myocatdial infarction (AM) .Methods:TFPI antigen (TFPI: Ag) and TFPI activity (TFPI:A) were measured by enzyme linked inmunosorbent assay and chromogenic peptide substrated method, respectively. Results:20 AP patients and 20 AMI patients were enrolled. There was no significant diff-envece in TFPI: Ag level letween patients and controls (P > 0.05 ). But patients' TFPI: Ag increased significantly and the values in patients with AMI increased more (AM vs controls, P < 0.001; AP is controls, P < 0. 01). Having recieved thrombolytic therapy with streplokinase, ten AMI patients were found to have elevated TFPI :Ag and TFPI: A in their plasma. Conclusion: Owing to the consumption of TFPI, patients with advanced coronary heart diseases didn't show responsive increase of TFPI: Ag, but they still had compensatory increase of TFPI:A. After thrombolytic Therapy , patients' coronary flow was improved, The elevated TFPT Level demonstrated that enhanced myocardial dynamic activity can promote the production of TFPI.