冠心病的抗凝血酶Ⅲ与纤溶改变及其临床意义  

Changes of antithrombin Ⅲ and fibrinolysis in coronary heart disease and its clinical significance

作　　者：蒲晓群[1] 张之炯[1] 郑艳珍 王振华[1] 

机构地区：[1]湖南医科大学附属湘雅医院心内科,长沙410008

出　　处：《临床心血管病杂志》1998年第6期332-334,共3页Journal of Clinical Cardiology

摘　　要：目的：研究冠心病的抗凝血酶Ⅲ（AT-Ⅲ）及纤溶改变特点并探讨其临床意义。方法：对冠心病组（34例）及对照组（30例）的抗凝血酶Ⅲ抗原（AT-Ⅲ：Ag）、抗凝血酶Ⅲ活性（AT-Ⅲ：a）、纤溶酶原抗原（PLG：Ag）、纤溶酶活性（PL：a）、组织型纤溶酶原激活剂活性（t－PA：a）、纤溶酶原激活剂抑制剂活性（PAI：a）和D-二聚体（D-dimer）进行检测和分析。结果：冠心病组的AT-Ⅲ：a显著降低（P＜0．01），PAI；a显著增高（P＜0．01），PL：a及D-dimer显著增高（P＜0．05，0．01）。t－PA：a与PL：a，t－PA：a、PL：a与D-dimer呈正相关。冠心病组中，不稳定型心绞痛及冠状动脉多支病变者与稳定型心绞痛及单支病变者比较，PL：a、t－PA：a、PAI：a及D-dimer增高尤显（均P＜0．05）。结论：冠心病特别是不稳定型心绞痛及冠状动脉多支病变者存在高凝状态和纤溶活性增高。Objectives:To study the clinical siedficance of changes of antithrombin Ⅲ and fibrinolysis in coronary heart disease. Methods:: Antithrombin Ⅲ antigen (AT-Ⅲ： Ag), antithrombin Ⅲ activity (AT-Ⅲ:a),plasminogen antigen (PLG: Ag),plasmin activity (PL:a),tissue plasminogen activator activity (t-PA:a),plasminogn activator inhibitor activity(PAI:a) and ixdimer were studied in 34 cases of coronary heart disease (CHD) and30 normal controls. Results:AT-Ⅲ:a was significantly lowered (P <0.01) ； PAI: a, PL: a and D-dimer were significantly increased (P < 0.01, 0.05 & 0.01 respectively)in CHD. There were postive correlations between t-PA: a and Ddimer (r = 0.529, P r0.01),t-PA:a and D-dimer(r = 0. 795, P <0.01),and PL:a and D-dimer (r=0.587, P<0.01). In patients with stable angina (SA) and unstable angina (UA) PL: a, t-PA: a, and D-dimer were significantly increased in later (P <0.05). Patients with multivessel disease showed much decreased AT-Ⅲ:a and increased PL:a,t-PA:a and D-dimer than single ves-sel disease (P＜0.05). Conclustiou： There are increase of coagulability and fibrinolysis in CHD especially in UA and multivessel disease.

关 键 词：冠心病 抗凝血酶Ⅲ 凝血纤溶系统 

分 类 号：R541.4[医药卫生—心血管疾病]