血浆组织因子及其途径抑制物对急性心肌梗死患者雷帕霉素支架置入后血栓形成的影响  

Impact of Plasma Tissue Factor and Tissue Factor Pathway Inhibitor Levels in Acute Myocardial Infarction Patients with Thrombosis after Implantation of Sirolimus-eluting Stents

作　　者：齐晓云[1] 徐萍[1] 杨洋[1] 李春华[1] 王万粮[1] 东洋[1] 

机构地区：[1]沈阳医学院沈洲医院心内科,沈阳110002

出　　处：《中国医科大学学报》2011年第7期639-641,共3页Journal of China Medical University

基　　金：沈阳市科技局计划项目(1071165-9-00;1063231-3-00);沈阳医学院优秀人才培养项目(20103047)

摘　　要：目的通过测定急性心肌梗死(AMI)患者直接经皮冠状动脉雷帕霉素支架置入前后血浆组织因子(TF)、组织因子途径抑制物(TFPI)水平的变化,探讨TF、TFPI对雷帕霉素支架置入后血栓形成的影响。方法 129例急诊行支架治疗的AMI患者分别置入雷帕霉素支架(n=124)和金属裸支架(n=25)。用ELISA法检测患者术前和术后24h、48h、1周外周静脉血TF、TFPI水平。比较雷帕霉素支架组与金属裸支架组不同时点TF、TFPI水平的变化并观察临床支架后血栓形成事件。结果术后24h、48h、1周时雷帕霉素支架组TF水平均明显高于金属裸支架组(P<0.05);术后24h时TFPI水平雷帕霉素支架组明显低于金属裸支架组(P<0.01);术后48h及1周时2组TFPI水平无统计学差异(P>0.05)。共发生支架后血栓形成3例,均为雷帕霉素支架组。结论 AMI支架治疗后,雷帕霉素支架可使TF表达升高,这可能是导致雷帕霉素支架内血栓形成的重要因素。Objective To measure the levels of plasma tissue factor （TF） and tissue factor pathway inhibitor （TFPI） before and after the implantation of bare metal stent （BMS） or sirolimus-eluting stent （SES） in acute myocardial infarction patients （AMI）,and to investigate the impact of TF and TFPI on thrombosis.Methods Plasma TF and TFPI levels in AMI patients were measured by enzyme-linked immuno sorbent assay （ELISA） before,24 hours,48 hours and 1 week after stent implantation and the thrombosis events were observed.Results 24 hours,48 hours and 1 week after stent implantation,TF level of SES group was singnificantly higer than that of BMS group （P 0.05）.TFPI level of SES group were lower than that of BMS group （P 0.01） 24 hours after stent implatation,but no differences were found between the two groups 48 hours and 1 week after stent implatation （P 0.05）.Thrombosis occured in three cases of SES group.Conclusion Thrombosis in acute myocardial infarction patients after implantation of sirolimus-eluting stents may be associated with plasma TF level.

关 键 词：心肌梗死 经皮冠状动脉成形术 雷帕霉素 血栓 组织因子 组织因子途径抑制物 

分 类 号：R541.4[医药卫生—心血管疾病]