心房颤动的低纤溶状态  

Study on hypofibrinolysis state in atrial fibrillation

作　　者：刘应才[1] 赵华[1] 杭永能 龚秀清[1] 王惠兰[1] 魏宗德[1] 

机构地区：[1]泸州医学院附属医院心内科,四川泸州646000

出　　处：《临床心血管病杂志》2000年第5期196-198,共3页Journal of Clinical Cardiology

摘　　要：目的 :研究心房颤动 (房颤 )的纤溶系统改变及其临床意义。方法 :采用发色底物法测定 30例房颤患者(其中冠心病 14例 ,风湿性心脏病 16例 )和 2 5例正常人血浆组织型纤溶酶原激活剂活性 ( t- PA∶ a)和纤溶酶原激活剂抑制物活性 ( PAI∶ a) ;并测定血浆纤维蛋白原 ( Fg)浓度、凝血酶原时间 ( PT)和部分凝血活酶时间( APTT)。结果 :房颤患者与正常人相比 ,血浆 t- PA∶ a降低〔( 340 .0± 70 .0 )对 ( 480 .0± 5 0 .0 ) IU /L ,P <0 .0 1)〕;PAI∶ a升高〔( 90 0 .0± 80 .0 )对 ( 6 90 .0± 5 0 .0 ) AU/L,P <0 .0 1〕;PAI∶ a/t- PA∶ a比值增高〔( 2 .87±0 .89)对 ( 1.49± 0 .2 9) ,P <0 .0 1〕,而 Fg、PT、APTT无显著性差异 ( P >0 .0 5 )。风湿性心脏病房颤与冠心病房颤之间血浆 t- PA∶ a,PAI∶ a,PAI∶ a/t- PA∶ a比值及 PT、APTT均无显著性差异 ( P>0 .0 5 ) ,但前组血浆 Fg浓度较后组低〔( 2 .5 9± 0 .6 9)对 ( 3.35± 1.0 4) g/L,P <0 .0 5〕。结论 :房颤患者血浆存在低纤溶状态 ,表现为 PAI活性增加 ,t- PA活性降低。Objective:To study the change of fibrinolysis system and its clinical significance in atrial fibrillation.Method:Plasma levels of tissue plasminogen activator activity(tPA∶a),its inhibitor activity (PAI∶a),fibrinogen(Fg),prothrombin time (PT) and activated part thromboplastin time (APTT) were measured in plasma from 30 patients with chronic atrial fibrillation.Sixteen patients had rheumatic heart disease (RHD) and fourteen patients had coronary heart disease (CHD).Levels were compared with those found in the plasma of 23 healthy subjects.Result:Patients with atrial fibrillation had higher plasma levels of PAI∶a,PAI∶a/tPA∶a ratio and lower tPA∶a level than controls (P 0.01 ).No significant differences were found in PT and APTT between atrial fibrillation and controls (P> 0.05 ).No significant differences were also found in tPA∶a and PAI∶a between rheumatic and nonrheumatic fibrillation (P> 0.05 ),but the atrial fibrillation with CHD showed elevated levels of fibrinogen (P< 0.05 ).Conclusion:Atrial fibrillation shows a hypofibrinolytic state caused by elevated PAI∶a and lowed tPA∶a.This may contribute to increased risk of thrombosis.

关 键 词：心房颤动 组织型纤溶酶原激活剂 纤维蛋白原 

分 类 号：R541.750.2[医药卫生—心血管疾病]