急性冠脉综合征患者抗Ⅹa因子、抗Ⅱa因子的变化及低分子质量肝素的干预作用  

Change of the levels of plasma anti-Ⅹa,anti-Ⅱa in acute coronary syndromes and the influence of low-molecular-weight heparin on plasma anti-Ⅹa and anti-Ⅱa levels

作　　者：汪玮[1] 孙宝贵[1] 戴秋艳[1] 吴莹[1] 

机构地区：[1]上海交通大学附属第一人民医院心内科,上海200060

出　　处：《中国实用内科杂志：临床前沿版》2006年第1期108-110,共3页

基　　金：上海市卫生局课题(No.局034037)

摘　　要：目的 观察急性冠脉综合征（ACS）患者抗Xa因子、抗Ra因子的变化及低分子肝素（LMWH）的干预作用。方法 将上海交通大学附属第一医院2003—01—2003—09收治的24例ACS患者和10例正常人（作对照）纳入研究对象。采用发色底物法测定血浆中的抗Xa因子、抗Ⅱa因子。ACS患者用LMWH抗凝治疗并分别于入院即刻，LMWH注射后4h、注射后24h、注射7d后观察抗Xa因子和抗Ⅱa因子的变化。结果 （1）ACS患者血浆抗Xa因子和抗Ⅱa因子明显高于正常者（P〈0.01）。（2）抗Xa因子在LMWH注射后4h、24h、7d较注射前明显增加（P〈0.01），注射后4h达高峰，以后逐渐下降；抗Ⅱa因子在LMWH注射后4h、24h、7d较注射前明显增加（P〈0．01），在注射后24h达高峰。结论 ACS患者血浆抗Xa因子升高与ACS的发病机制及LMWH的干预作用有关。LMWH对Xa因子的作用较Ra因子强，且达峰时间短。Objective To observe the change of the levels of plasma anti - X a, anti - Ⅱ a in acute coronary syndromes and the influence of low - molecular - weight heparin （LMWH） on plasma anti - X a and anti - Ⅱ a levels. Methods Plasma anti - Xa and anti- Ⅱ a were measured with the specific chromogenic substrate in 24 patients with ACS and 10 healthy controls from Jan. 2003 to Sep. 2003. LMWHs were administrated to the ACS patients. Plasma anti - Xa and anti - Ⅱ a were measured immediately, and at 4 h, 24 h, and day 7 after initial injection. Results Plasma anti - Xa and anti - Ⅱ a levels in ACS patients were significantly higher than those in controls （P 〈 0. 01 ） . Plasma anti - X a levels of 4 h, 24 h and 7th day after initial injection were significantly increased after the treatment （P 〈0. 01 ） . Plasma anti - X a levels reached the peak at 4 h after initial injection, then gradually decreased. Plasma anti - Ⅱ a level of 4 h, 24 h and the 7th day after initial injection were also significantly increased after the treatment （P 〈0. 01 ）, and reached the peak at 24 h after initial injection. Conclusion The higher anti - X a activity in ACS patients is associated with the pathogenesis of ACS and the intervention of LMWH. The influence of LMWH on anti - X a activity is stronger and quicker than on anti- Ⅱ a.

关 键 词：急性冠脉综合征 低分子质量肝素 抗XA因子 

分 类 号：R5[医药卫生—内科学]