急性心肌梗塞溶栓治疗前后凝血及纤溶系统的动态分析  

Clinical Significance and Dynamic Analysis of Coagulative and Fibrinlytic Parameters in the Patients with Acute Myocardial Infarction During Thrombolytic Therapy

作　　者：耿美蓉[1] 张金峰 

机构地区：[1]哈尔滨医科大学附属肿瘤医院检验科,黑龙江哈尔滨150040

出　　处：《中国伤残医学》2008年第3期28-30,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：为了探讨急性心肌梗塞(AMI)患者溶栓治疗前后凝血及纤溶系统动态变化及临床意义,对20AMI例患者(均于6小时内接受溶栓治疗)在溶栓前,溶栓后2小时,4小时,24小时,48小时测定凝血酶原时间(PT),活化的部分凝血活没时间(APTT),凝血酶时间(TT),纤维蛋白含量(FG),抗凝血酶Ⅲ活性(ATⅢ:C)及D-二聚体含量(D-Dimer),并与正常对照组(n=20)进行比较。结果表明:与溶栓前比较,溶栓治疗后2小时,纤维蛋白原含量大幅度降低,(P<0.05)D-二聚体含量明显增高,(P<0.05)PT,APTT,TT明显延长,(P<0.05);48小时的指标均恢复到溶栓前水平,(P>0.05)溶栓治疗前后抗凝血酶Ⅲ活性无明显变化。(P>0.05)结论:溶栓治疗后AMI患者凝血活性明显减弱,纤溶活性明显增强,对指导临床治疗有一定意义。Objective： To explore clinical significance and dynamic changes of coagulative and fibrinolytic parameters in the patients with acute myocardial infarction（AMI） before and after thrombolytic therapy. Methods： The levels of prothrombin time （PT）, activated partial thromboplasmin（APTT）, thrombin time （TT）, fibrinogen concentration, D-dimer concentration, anti-- thrombin Ⅲ activity were measured in 20 AMI patients before and at 2,4,24,48 hours after treatment, compared with control group. Results： Fibrinogen concentration were significantly decreased （P〈0.05）, D--Dimer concentration significantly increased （P〈0.05）, PT. APTT. TT significantly prolonged at 2 hour after thrombolytic therapy（P〈0. 05）. At 48 hour after thrombolytic therapy, above parameters returned to the level before treatment（P〉0.05）. The anti-thrombinⅢ activity had no significant alterations before and after treatment（P〉0. 05）. Conclusion： After thrombolytic therapy, the fibrinolytic activity was significantly increased, coagulative activity was significantly decreased. Such dynamic changes can play a role for clinical therapy.

关 键 词：凝血 纤溶 急性心肌梗塞 溶栓治疗 

分 类 号：R542.22[医药卫生—心血管疾病]