急性冠状动脉综合征冠状动脉支架置入术凝血指标变化  

The changes of blood coagulation indices after percutaneous coronary intervention

作　　者：吴俊[1] 杨敏[1] 赵洁[1] 张正[1] 

机构地区：[1]北京大学人民医院检验科,北京100044

出　　处：《中国综合临床》2008年第12期1217-1219,共3页Clinical Medicine of China

摘　　要：目的了解急性冠状动脉综合征患者行支架置入术（PCI）凝血指标变化的规律，为临床抗凝治疗提供依据。方法急性冠状动脉综合征行支架置入术患者34例，分别于介入前及术后1、4、24、48h留取血样，检测凝血酶-抗凝血酶复合物（TAT）、血管假性血友病因子（vWF）、蛋白C、抗凝血酶、纤维蛋白原、D-二聚体不同时间段水平并进行统计分析。结果PCI术后TAT持续增高，蛋白C、抗凝血酶持续下降，vWF、D-二聚体持续升高与TAT相一致，纤维蛋白原呈一过性降低。结论PCI术后存在凝血酶产生增加与vWF、D-二聚体的增高时相一致，同时抗凝血系统蛋白活性下降。凝血高活性至少持续48h，以后逐渐恢复正常。Objective To investigate the changes of blood coagulation indices during the percutaneous coronary intervention（PCI ） ,so as to provide evidence for anticoagulation therapy. Methods 34 acute coronary syndrome patients were enrolled ,whose blood sample was taken at baseline, 1 h ,4 h ,24 h, and 48 h after PCI operation. Thrombin-antithrombin complex （ TAT）, vWF, protein C, antithrombin, fibrinogen, D-dimer were tested. The result was processed by statistical software. Results After PCI, TAT continued to rise, protein C and antithrombin drop down,the vWF and D-dimer rose with TAT, and fibrinogen transiently drop down. Conclusion The thrombin produces more quickly after PCI, its time phrase is coordinated with vWF and D-dimer, at the same time the anticoagulation system drops down. High anticoagulation at least maintains within 48 h and then tends to be normal.

关 键 词：急性冠状动脉综合征 支架置入术 凝血酶 抗凝血酶 蛋白C 

分 类 号：R541.4[医药卫生—心血管疾病]