急性冠脉综合征患者血浆RAS与纤溶系统的相关性分析

目的探讨肾素-血管紧张素系统（RAS）与纤溶系统在急性冠脉综合征（ACS）发生发展中的相互作用。方法选取ACS患者80例,急性心肌梗死（AMI）组40例,不稳定型心绞痛（UA）组40例,同时设立对照组40例,比较3组间血管紧张素Ⅱ（AngⅡ）与组织纤溶酶原激活物抑制剂-1（PAI-1）含量的差异,同时对80例ACS患者进行AngⅡ与PAI-1相关性分析。在ACS患者中选取30例,进行血管紧张素转换酶抑制剂（ACEI）干预性研究,其中ACEI组15例,非ACEI组15例,两组在常规药物治疗的基础上,ACEI组加用贝那普利10 mg/d,2周~8周后再次测定PAI-1的水平,比较PAI-1水平下降的情况。结果 ACS患者AngⅡ与PAI-1含量明显高于对照组（P〈0.001）,其中AMI组AngⅡ与PAI-1水平又明显高于UA组（P〈0.001）。AngⅡ与PAI-1的水平呈显著正相关（b＇=0.457,P〈0.05）。2周~8周后使用贝那普利进行治疗的ACS患者较未使用贝那普利的患者血中PAI-1的水平明显下降（P〈0.001）。结论 RAS与纤溶系统不是相互独立地作用于心血管系统,而是密切相关,协同作用,共同参与了

Relationship between Rennin Angiotensin System and Fibrinolytic System in Acute Coronary Syndrome

Objective To investigate the relationship between rennin angiotensin system（RAS） and serum fibrinolytic system in patients（pts） with acute coronary syndrome（ACS）.Methods There were three groups in this study：Acute myocardial infarction group（AMI,n=40）,Unstable angina group（UA,n=40） and control group（n=40）.The angiotensin Ⅱ（AngⅡ） and plasminogen activator inhibitor-1（PAI-1） levels were measured simultaneously and compared in two groups.At the same time,the correlation of AngⅡ and PAI-1 in pts with ACS（n=80） were analyzed.The effect of angiotensin-converting enzyme inhibition（ACEI） on PAI-1 was study in 30 pts with ACS,15 pts received benazepril（10 mg/d）,and 15 pts were as controls.Results The plasma levels of AngⅡ and PAI-1 in AMI and UA groups were increased significantly as compared with that in control group（P0.001）,and plasma levels of AngⅡ and PAI-1 in AMI group were much higher than that in UA group（P0.001）.The level of PAI-1 in plasma was increased with the increase of AngⅡ.PAI-1 was positively correlated with AngⅡ（b＇=0.457,P0.05）.In the ACEI group,the level of PAI-1 was decreased significantly compared with that in controls（P0.001）.Conclusion There was close relationship between RAS and fibrinolytic system.RAS was involved in the regulation of fibrinolytic function.Short-term interruption of the RAS by ACEI could decrease PAI-1.