急性冠状动脉综合征患者血液凝固性加强

目的通过研究急性冠状动脉综合征患者凝血状态的变化,探讨急性冠状动脉综合征患者的发病与血栓前状态的关系,以期对危重冠心病患者及早作出诊断和治疗。方法选择急性冠状动脉综合征患者86例,对照组为稳定型心绞痛患者75例,以酶联免疫吸附法测定两组患者血浆凝血酶原片段1和2、可溶性纤维蛋白单体复合物等凝血分子标志物的含量并进行比较。结果急性冠状动脉综合征患者血浆凝血酶原片段1和2及可溶性纤维蛋白单体复合物较稳定型心绞痛患者均显著升高(1.21±0.23nmolL比0.76±0.20nmolL;85.4±12.4mgL比68.7±13.8mgL,P均<0.001)。急性冠状动脉综合征合并2型糖尿病时血浆凝血酶原片段1和2及可溶性纤维蛋白单体复合物较不伴有2型糖尿病时显著升高(1.28±0.19nmolL比1.16±0.20nmolL;89.8±12.4mgL比82.7±13.7mgL,P均<0.05)。急性冠状动脉综合征合并原发性高血压时血浆凝血酶原片段1和2及可溶性纤维蛋白单体复合物较不伴有原发性高血压时显著升高(1.26±0.24nmolL比1.16±0.20nmolL;90.0±12.8mgL比82.7±13.7mgL,P均<0.05)。结论稳定型心绞痛患者的凝血系统处于稳定状态,而急性冠状动脉综合征患者处于高凝状态,合并2型糖尿病或原发性高血压的急性冠状动脉综合征患者高凝状态更显著,提示高凝状态与急性冠状动脉综合征的发病密切相关。

The Study of Hypercoagulable State in Patients with Acute Coronary Syndrome

Aim To study the relationship between the occurrence of acute coronary syndrome (ACS) and hypercoagulable state. Methods Plasma prothrombin fragment 1 and 2 (F_ 1+2) and soluble fibrin monomer complex (SFMC) were detected by enzyme-linked immunosorbent assay for 86 patients with ACS and 75 patients with stable angina pectoris (SAP). Results Compared with SAP group, the plasma levels of F_ 1+2 and SFMC in ACS group were significantly higher (F_ 1+2: 1.21± 0.23 nmol/L vs 0.76±0.20 nmol/L, p<0.001; SFMC: 85.4±12.4 mg/L vs 68.7±13.8 mg/L,p<0.001). The plasma levels of F_ 1+2 and SFMC in ACS patients with diabetes mellitus were significantly higher than those in ACS patients who had no other diseases (F_ 1+2: 1.28±0.19 nmol/L vs 1.16±0.20 nmol/L, p<0.05; SFMC: 89.8±12.4 mg/L vs 82.7±13.7 mg/L,p<0.05). The plasma levels of F_ 1+2 and SFMC in ACS patients with essential hypertension were significantly higher than those in ACS patients who had no other diseases (F_ 1+2: 1.26±0.24 nmol/L vs 1.16±0.20 nmol/L, p<0.05; SFMC: 90.0±12.8 mg/L vs 82.7±13.7 mg/L, p<0.05). Conclusion Patients with SAP were in stable thrombotic state, patients with ACS were in unstable thrombotic state, the occurrence of ACS was closely related to hypercoagulable state.