急性心肌梗塞溶栓和不溶栓血浆纤维蛋白原水平的动态变化及临床意义

观察４０例急性心肌梗塞（ＡＭＩ）血浆纤维蛋白原（Ｆｇ）水平的动态变化。其中尿激酶溶栓治疗１８例。结果：ＡＭＩ血浆Ｆｇ水平高，且在一周内进行性增高；溶栓治疗后Ｆｇ－过性显著降低，但很快即出现反弹；溶栓组和未溶栓组Ｆｇ均在５ｄ左右达高峰，１周病死率分别为５．５％和２２．７％；存活组Ｆｇ水平的演变与溶栓组一致，死亡组与未溶栓组一致。提示溶栓后接着用抗凝剂是必要的，不适合溶栓者仍可考虑用抗凝剂，抗凝剂维持时间可能应达５ｄ左右，血桨Ｆｇ水平的动态观测对估计预后有一定意义。

DYNAMIC CHANGE AND SIGNIFICANCE OF PLASMA FIBRINOGEN LEVEL IN ACUTE MYOCARDIAL INFARCTION TREATED AND UNTREATED WITH THROMBOL YTIC THERAPY

s: The dynamic change of plasma fibrinogen(Fg)level in 40 patients with acute myocardial infarction(AMI) was observed. Thrombolytic therapy was administered in 18 cases. The results showed that plasma Fg level in AMI was high and progressively increased within the first week. Secondary Fg level increasing occurred rapidly after itS transient overt decreasingas the result of thrombolytic therapy.FG level in both thrombolytic and nonthrombolytic group reached a peak on the fifth day of AMI.The first week mortality was 5.5%in thrombolytic group and 22.7%in nonthrombolytic group.We conclude that subsequent anticoagulant following thrombolytic therapy is necessary.Anticoagulant Should even be used in patients who was notsuitable to thrombolytic therapy.Furthermore,anticoagulant treatment should be las ted 5 days.Dynamic observation of plasma Fg level has certain clinical significance in assessing prognosis of AMI.