冠心病介入治疗后t-PA和PAI及vWF∶Ag活性变化

目的 对46例经皮腔内冠状动脉成形术(PTCA)成功患者进行6个月随访,通过t-PA活性(t-PA:A)、PAI活性(PAIs:A)、vW因子抗原(vWF:Ag)的检测以观察内皮细胞纤溶活力变化和患者预后的关系。方法 根据冠状动脉造影结果将患者分为无再狭窄组35例和再狭窄组11例。所有患者均在PTCA术前及术后1h、1月、3月、6月肘静脉抽血,检测t-PA:A、PAIs:A和vWF:Ag含量。 结果 再狭窄组血浆t-PA:A术后上升,随访中下降;PAIs:A呈上升趋势,无再狭窄组血浆t-PA:A水平在术后1h上升,且在以后随访中仍保持上升趋势,其PAIs:A逐步下降(P<0.05);二组相比,再狭窄组PAIs:A水平在术后3个月和6个月时分别比无再狭窄组增高48％和66％(P均<0.05)。vWF:Ag水平,无再狭窄组术后恢复至术前水平,而再狭窄组术后始终比术前增高。 结论 异常增高的PAIs:A及vWF:Ag水平对血管成形术后再狭窄,可能起重要作用。

Study on Relationship Between Changes of Fibrinolytic Activity and Prognosis after Successful PTCA

Objective To analyse possible association between changes of fibrinolytic activity and restenosis after successful percutaneous transluminal coronary angioplasty (PTCA). Methods Forty-six patients with coronary heart disease undergoing PTCA were followed up with angiography during 6 months, and were devided into no-restenosis group(A) and restenosis group(B). The plasma t-PA : A, PAIs : A, and vWF; Ag levels of all patients were determined before PTCA and Ih, 1m, 3m, 6m after PTCA. Results The difference in plasma t-PA : A levels before and after PTCA between group A and B was not significant. The levels of plasma PAIs : A in group B at 3m, 6m after PTCA were higher than those in group A(P <0. 05). The levels of vWF : Ag at Ih after PTCA were increased in both groups, but were decreased in 6-month follow-up in group A,yet were still higher in group B than those in group A(P <0. 05). Conclusion The results indicate that abnormality of PAIs activity and vWF ? Ag may play an important role in restenosis after successful PTCA.