降纤酶对不稳定型心绞痛凝血及纤溶的影响

目的：探讨降纤酶对不稳定型心绞痛（UAP）凝血及纤溶系统的影响，了解降纤酶治疗的临床价值。方法：选择符合UAP诊断标准的患者63例，按随机、双盲对照法分为治疗组及对照组，治疗组在UAP常规治疗的基础上用降纤酶10u加入0．9％氯化钠注射液100ml，1h内ivd，qd，共5d；对照组仅用0．9％氯化钠注射液100ml．ivd。治疗前后空腹抽血检查血浆纤维蛋白原（Fib）浓度、D-二聚体、组织型纤溶酶原激活物（tPA）、纤溶酶原激活物抑制因子（PAI—1）。结果：治疗组治疗后tPA增加，Fib及PAI—1降低，较对照组变化具有显著性；对照组tPA增加．余指标变化差异无显著性.治疗中未出现明显的不良反应。结论：降纤酶能安全、有效地通过降低血浆纤维蛋白原浓度．增加纤溶活性，从而达到治疗UAP的显著临床效果。

The Change of the Coagulation and Fibrinolytic Systems in Patients with Unstable Angina Pectoris after the Treatment of Defibrase

Objective:To study the effects of defibrase (DF) on the change of coagulation and fibrinolytic systems in patients with unstable angina pectoris (UAP). Method:63 cases of UAP were randomly divided into two groups. On the basis of conventional oral remedy of UAP, the DF group (33 cases ) was treated with DF with a dose of 10U in 0.9% sodium choride 100ml,iv drip, daily, five days. The control group (30 cases) was treated with 0.9% sodium choride. Plasma fibrinogen, D-dimer, tissue plasminogen activator(t-PA) , plasminogen activator inhibitor-1 (PAI-1) activity were detected before the therapy and seventh day after the therapy respectively with ELISA enzymatic and chromogenic reaction method. Result:There was a significant drop of plasma fibrinogen, PAI-1. The t-PA of plasma was also increased after the therapy in the DF group compared with the placebo group. The t-PA of plasma was also increased but the others did not reach statistical significance after the therapy in the control group. Conclusion:DF has its obvious effects on UAP and on improving the hemorrheological properties and fibrinolytic systems. Injections for the treatment with defibrase during the acute phrase of UAP is efficient and safe.