急性心肌梗死及脑梗死患者组织因子、组织因子途径抑制物、因子Ⅶ的检测及临床意义  

Value of plasma tissue factor, tissue factor pathway inhibitor and factor Ⅶ assessments in patients with acute myocardial and cerebral infarction

作　　者：熊石龙[1] 王前[1] 郑磊[1] 李俊玲[2] 文志斌[3] 贺石林[3] 

机构地区：[1]南方医科大学南方医院检验医学中心,广东广州510515 [2]中南大学湘雅三医院超声科,湖南长沙410013 [3]中南大学湘雅医学院生理学系止血与血栓研究室,湖南长沙410078

出　　处：《南方医科大学学报》2007年第12期1821-1823,共3页Journal of Southern Medical University

基　　金：国家自然科学基金(39830180)~~

摘　　要：目的探讨急性心肌梗死及脑梗死患者组织因子途径相关凝血因子的变化及其临床意义。方法观察分析69例急性心肌梗死、71例急性脑梗死患者以及50名健康老年人组织因子、组织因子途径抑制物、因子VII等指标。血浆中组织因子(TF)和组织因子途径抑制物(TFPI)活性测定采用发色底物法,抗原测定用ELISA法;凝血因子VII(FVII)促凝活性测定采用一期凝固法,FVIIa水平测定采用重组可溶性组织因子法。结果与对照组相比,急性心肌梗死患者血浆中TF活性、TF抗原、TFPI活性与TFPI抗原均显著增加(P均<0.05),而血浆中FⅦ:C无显著变化(P>0.05),但FⅦa显著增加(P<0.05);急性脑梗死患者血浆中TF活性、TF抗原均升高(P均<0.05),TFPI活性、TFPI抗原均降低(P均<0.05),而血浆中FⅦ:C、FⅦa显著增加(P均<0.05)。两病例组相比,急性心肌梗死组TF活性、抗原升高更为显著(P均<0.05);急性心肌梗死组TFPI活性、抗原增加,而急性脑梗死组均降低,差异具有显著性意义(P均<0.05);FⅦ:C在急性脑梗死组显著升高(P<0.05),而FⅦa两组差异并无显著性(P>0.05)。结论急性心肌梗死和急性脑梗死患者均存在组织因子途径的启动,血栓形成风险增加,测定上述指标对了解疾病发展趋势具有辅助作用。Objective To study the clinical implications of changes in plasma tissue factor （TF）, tissue factor pathway inhibitor （TFPI） and factor Ⅶ （FⅦ） after the onset of acute myocardial infarction （AMI） and acute cerebral infarction （ACI）. Methods Sixty-nine patients with AMI, 71 with ACI and 50 age-matched healthy volunteers were enrolled in this study. Blood samples were obtained from the healthy subjects and from the patients at the early stage of AMI and ACI onset for examination of plasma TF and TFPI activity using chromogenic assay, and the plasma TF and TFPI antigens were measured by enzyme-linked immunosorbent assay （ELISA）. The plasma FⅦ coagulation activity （FⅦ：C） was also measured, and the plasma FVIIa determined using soluble TF assay. Results Compared with the healthy control group, AMI patients had significantly enhanced plasma TF and TFPI activities and elevated TF and TFPI antigen levels （P〈0.05）, with also markedly increased FVIIa （P〈0.05） but comparable FⅦ：C （P〉0.05）. In ACI patients, the plasma TF activity and antigen were obviously increased in comparison with the control group （P〈0.05）, but plasma TFPI activity and antigen were lowered （P〈0.05）, and both the FⅦ：C and F Ⅶ a were markedly higher （P〈0.05）. Significant differences were noted in plasma TF and TFPI activities and their antigen levels as well as in FVII：C, but not in FVIIa between AMI and ACI patients. Conclusion Following the onset of AMI and ACI, TF pathway is initiated and the risk of thrombogenesis increases, and the assessment of TF pathway is therefore of value for understanding the development of the condition.

关 键 词：急性心肌硬死 急性脑梗死 组织因子 组织因子途径抑制物 

分 类 号：R542.22[医药卫生—心血管疾病] R743.3[医药卫生—内科学]