冠心病患者冠状动脉介入治疗前后tPA和PAI的变化

目的观察冠心病患者行冠状动脉介入治疗（PCI）手术前后血浆组织型纤溶酶原激活物（tPA）及纤溶酶原激活抑制剂（PAI）的动态变化。方法采用ELISA法对50例冠心病患者在PCI（包括PTCA和冠脉支架植入）手术前、手术后即刻和手术后4 d测定血浆中tPA和PAI的活性,并将冠心病患者的tPA、PAI浓度和tPA/PAI比值进行比较。结果冠心病患者tPA活性较正常对照组明显降低,PAI活性明显增高,在PAI手术后即刻tPA活性较手术前明显降低,但术后4 d回升,较正常对照组仍然明显降低,较PCI手术前无明显差异 冠心病患者PAI活性在PCI手术后明显升高,与手术前比较具有明显差异性,但术后4 d下降,,较PCI手术前无明显差异,但仍高于正常对照组。结论冠心病患者PCI手术存在着内皮损伤,导致手术后出现纤溶功能降低,而纤溶功能的低下会影响PCI的治疗效果。

The Dynamic Changes of tPA and PAI Activity after and before PCI in Patients with CAD

Objective To monitor the dynamic changes of tissue type plasminogen activator(t-PA) and plasminogen activator inhibitor-I(PAI) activity after and before PCI in patientswith CAD.Methods tPA and PAI activity were measured before and after PCI at 0,4days in 50 patients with CAD.Results The tPA activity was obviously low before and after PCI in patients with CAD,it began to rise gradually after PCI 4 days,but it also lower than the control,The PAI activitywas obviously high before and after PCI in patients with CAD,but levels of PAI began to decrease gradually after PCI 4 days.Conclusion The plasma fibrinolytic function is significantly lower in patients with CAD than that before PCI.The levels of plasma fibrinolytic function will related to restenosis after PCI.