冠心病患者纤溶系统的异常变化

目的探讨冠状动脉病变中血清纤维蛋白原（Fg）、组织型纤溶酶原激活物（t-PA）、血浆D-二聚体（D-Dimer）与血栓形成关系，并就其作用机理进行研究，为临床治疗提供科学依据。方法急性心肌梗死（AMI）组28例、不稳定心绞痛（UAP）组24例、稳定心绞痛（SAP）组30例和正常对照组20例。分别检测血清Fg、血浆D-Dimer、t-PA及其抑制物（PAI）活性，并对照比较其含量与冠状动脉粥样硬化血栓形成的关系。结果血浆t-PA活性：AMI和UAP明显低于SAP与健康对照组（P〈0．01）；AMI组和UAP组之间，SAP组与健康对照组之间差异无统计学意义（P〉0．05）。血浆PAI活性、D-Dimer和Fg含量：AMI和UAP组明显高于SAP和健康对照组（P〈0．01）；AMI组和UAP组之间，SAP组与健康对照组之间差异无统计学意义（P〉0．05）。结论监测冠状动脉粥样硬化患者血清中血清Fg含量、t-PA、D-Dimer含量，可以及时判断凝血和纤溶功能失衡状况，预防和干扰血栓形成，提高患者良性预后。

Changes of related factor of thrombosis in coronary atherosclerosis patients

Objective To investigate association between Fg,t-PA,D-Dimer and thrombosis in diseaseof coronary artery, and to study action roeehanisms. Methods Plasma fibrinogen, D-Dimer, tissue type plasminogen activator and plasminogen activator inhibitor were measured in acute myocardial infarction group(n= 28) , unstabh angina pectofis group (n = 24) , stable angina pectoris group (n = 30) , and healthy controls (n = 20), and contrasted relation between content and coronary atherosclerosis thrombosis. Results Plasma t-PA :in acute myocardial infarction group and unstable angina pectoris group, the level of t-PA were lower than stable angina pectoris group and healthy controls(P < 0. 01), and there were no difference between acute myocardial infarction group and unstable angina pectofis group and between stable angina pectoris group and healthy con- trois(P >0. 05). Plasma PAl, D-Dimer and Fg:content in acute myocardial infarction group and unstable angina pectoris group increased marked(P < 0. 01) ; and there were no difference between acute myocardial infarction group and unstable angina pectoris group and between stable angina pectoris group and healthy controls(P > 0. 05). Conclusion To monitor content of Fg, t-pA , D-Dimer in patients of coronary atherosclerosis may judge disequilibrium status of blood coagulation and fibrinolysis, prevent and confuse of thrombosis, increase of good prognosis.