冠心病患者血栓前状态的研究  

STUDIES ON THE PRETHROMBOTIC STATE IN PATIENTS WITH CORONARY HEART DISEASE

作　　者：周华兰[1] 江凤[2] 魏宗德[2] 

机构地区：[1]淮安市第二人民医院老年科,江苏淮安223002 [2]泸州医学院附属医院心血管研究所

出　　处：《泸州医学院学报》2004年第5期398-400,共3页Journal of Luzhou Medical College

摘　　要：目的 :观察冠心病患者血浆纤溶酶原激活物的抑制物 - 1(PAI- 1)、血栓素B2 (TXB2 )、6 -酮 -前列腺素F1α(6 -K -PGF1α)等反映血栓前状态分子标志物含量变化 ,并探讨它们与冠心病的关系。方法 :选择符合 1979年WHO诊断标准或经冠脉造影证实的冠心病患者 6 0例为冠心病组 ,其中 ,稳定型心绞痛 (SAP) 17例 ,不稳定型心绞痛 (UAP) 31例 ,急性心肌梗死 (AMI) 12例。同时 ,选择年龄、性别、等配对的正常志愿者 2 0例作为对照组。分别用酶联吸附双抗体夹心法、放射免疫法检测血浆PAI - 1和ET、TXB2 、6 -K -PGF1α含量。结果 :①冠心病患者血浆PAI- 1、ET、TXB2 含量显著高于对照组 (P <0 .0 1)、6 -K -PGF1α含量显著低于对照组 (P <0 .0 1)。②SAP、UAP、AMI三组患者血浆中PAI- 1、ET含量依次升高 ,差异均有显著性 (P <0 .0 5 ) ;TXB2 、6 -K -PGF1α含量在AMI、SAP、UAP三组之间比较 ,TXB2 在AMI组升高更显著 (P <0 .0 1) ,6 -K -PGF1α在AMI组下降更显著 (P <0 .0 1) ,而在SAP、UAP两组之间比较差异均无显著性 (P >0 .0 5 )。结论 :冠心病患者存在血栓前状态 ,表现为纤溶功能障碍、血管内皮细胞受损和血小板激活等。Objective:This study was designed to observe the change of the plasma plasminogen activator inhibitor-1(PAI-1) 、endothelin(ET)、thromboxane B_2 (TXB_2) and 6-Keto-prostaglandin F1 alpha (6-K-PGF_(1α)) levels in patients with coronary heart disease (CHD), and explore the relationship between them and the pathogenesis of CHD. Methods:The plasma PAI-1 level was measured by enzyme linked immunosorbent assay, and the plasma ET、TXB_2、6-K-PGF_(1α) levels were tested with radioimmunoassay in 60 patients with CHD and 20 healthy control subjects. Results:①The plasma PAI-1、ET、TXB_2 levels were significantly higher(P<0.01), and the 6-K-PGF_(1α) level was significantly lower(P<0.01)in patients with CHD than in healthy control subjects. ②The plasma PAI-1、ET、TXB_2 levels significantly increased with the exacerbation of CHD (P<0.05); TXB_2 level was significantly higher (P<0.01) while 6-K-PGF_(1α) level was significantly lower (P<0.01)in patients with acute myocardial infarction (AMI) than in patients with stable angina pectoris(SAP) and unstable angina pectoris(UAP) . However, TXB_2 and 6-K-PGF_(1α) levels in this study did not differ between SAP and UAP. Conclusion:The results suggest that there is a prethrombotic state in patients with CHD, manifested as impaired fibrinolysis 、vascular endothelin cells disfunction and platelet activation.

关 键 词：冠心病 纤溶系统 血管内皮 血小板 

分 类 号：R543.3[医药卫生—心血管疾病]