冠状动脉造影和PTCA术对冠心病纤溶活性的影响

目的 :观察选择性冠状动脉造影 （SCA）和 PTCA对冠心病纤溶活性的影响。方法 :对接受 SCA的 45例患者和 PTCA术后 19例患者的血浆组织型纤溶酶原激活物抗原 （t- PA:Ag）、纤溶酶原激活物抑制物 （PAI1 ）和纤维蛋白二聚体 （DD）含量进行动态观测。结果 :1SCA后 SCA正常组、稳定型和不稳定型心绞痛组 t- PA:Ag含量均显著升高 （P<0 .0 1） ,前者 2 4h,后者 72 h内恢复 ;活性无显著变化 ;t- PA:Ag升高程度以 SCA正常组最明显 ,显著高于稳定和不稳定型心绞痛组。 2 PTCA术后 t- PA:Ag,DD含量和 PAI1 活性均显著升高 ,PAI1 活性 3d内、t- PA :Ag 7d内恢复 ,DD含量 7d内仍高于术前。结论 :冠心病患者有 t- PA:Ag储存和释放障碍 ,SCA和 PTCA术后纤溶活性有增加趋势 ,可能与术前、术后抗血小板药物及术中、术后肝素应用有关。

Effect of fibrinolyticactivity in patients with coronary artery disease undergoing select coronary arteriographyand PTCA

AIM:To investigate the effects of fibrinolytic activity in patients with coronary artery disease underwent select coronary arteriography (SCA) and percutanous transluminal coronary angioplasty(PTCA). METHODS:Forty five patients underwent SCA and nineteen underwent PTCA. RESULTS:The plasma levels of tissue type plasminogen activator antigen (t PA:Ag) and corss linked fibrin degradation products (D dimer,DD) raised significantly in the groups with stable or unstable angina and the normal group after underwent SCA. At 24 h,elevated levels of t PA:Ag decreased but DD at 72 h. The elevated levels of t PA:Ag in normal group was higher than stable or unstable angina groups significantly. The activity of plasminogen activator inhibitor type 1(PAI 1) was unchanged. Underwent PTCA caused a significant increase in the plasma levels of t PA:Ag and DD and the activity of PAI 1. The elevated levels of activity of PAI 1 decreased to the pretreatment level during the period of 3 d after PTCA,but t PA:Ag during 7 d. In 7 d the levels of DD were higher than before underwent PTCA. CONCLUSION:The function of deposition and release t PA:Ag weaken in patients with coronary artery disease. The fibrinolytic activity raise after underwent SCA and PTCA,because of taken the drugs of anti platelet and heparin on pretreatment and after treated.