急性心肌梗死患者组织因子及组织因子途径激活抑制物水平的变化

目的探讨急性心肌梗死(AMI)患者组织因子(TF)及组织因子途径激活抑制物(TF-PI)的变化及临床意义。方法用ELISA法分别检测50例AMI患者及20例健康对照的外周血TF及TFPI的抗原水平。比较15例支架手术患者冠状窦内及外周血的TFPI水平。比较并发糖尿病和/或高脂血症AMI患者与无并发症者的TFAg及TFPIAg水平。结果AMI患者的TFAg及TFPIAg较正常人均明显升高(P<0.01);支架患者冠状窦内的TFPI水平明显低于其外周血(P<0.01);有并发症患者的TF及TFPI水平均明显高于无并发症患者(分别为P<0.01和P<0.05)。结论AMI患者外周血凝血活性增高,并发糖尿病和/或高脂血症AMI患者的凝血活性较无并发症患者高,血栓形成使冠状动脉腔内的TFPI消耗而降低。

The changes of tissue factor and tissue factor pathway inhibitor in acute myocardial infarction

Objective To investigate the changes of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) and clinical significance in acute myocardial infarction(AMI).Methods Serial blood samples were obtained from the coronary sinus undergoing revascularization by stent placement in 15 patients and from peripheral venous blood in 50 patients with AMI and 20 normal controls. Concentrations of TF and TFPI were determined by sandwich-type immunoassay.Results The levels of TF and TFPI in patients with AMI were significantly higher than that in normals controls, the level of TFPI in the blood of coronary sinus was significantly higher than that in the peripheral venous blood in the patients with stent treatment, the same results were obtained between the patients with complication and non-complication.Conclusion Procoagulant activity in patients with AMI increases and it more increases in patients with complication than non-complication, there was acute consumption of TFPI within the coronary circulation of patients with intracoronary thrombosis.