急性心肌梗死溶栓治疗与时间生物学特征的关系研究  

Research on relation of the chronobiology characteristic of acute myocardial infarction patients and thrombolytic therapy

作　　者：徐建[1] 许锦荣[1] 凌云[2] 陈玲[2] 关春红[2] 关振文[3] 

机构地区：[1]广东医学院第二附属医院急诊科,湛江524003 [2]广东医学院第二附属医院心血管内科,湛江524003 [3]广东医学院第二附属医院时间医学实验室,湛江524003

出　　处：《齐齐哈尔医学院学报》2012年第19期2593-2594,共2页Journal of Qiqihar Medical University

基　　金：湛江市科技计划项目(编号:2008C02023)

摘　　要：目的探讨急性心肌梗死患者使用尿激酶溶栓治疗的疗效与发病昼夜节律的关系。方法选择急性心肌梗死患者80例,均于发病3h内开始溶栓治疗。按照发病时间分为上午组45例,其他时间组35例,分别于溶栓前和溶栓后30min、120min对患者的抗凝和纤溶活性进行测定,并判断溶栓3h后的再通情况。结果上午组患者的再通率显著低于其他时间组(P<0.05),且上午组患者的PAI-1水平显著高于其他时间组(P<0.05),其他指标间差异无统计学意义(P>0.05);溶栓前以及溶栓后30min、120min未通患者的PAI-1抗原水平和PAI-1活性均高于再通患者(P<0.05)。结论急性心肌梗死溶栓的疗效与患者的时间生物学特征有关,溶栓治疗存在上午抵抗现象,可能与PAI-1抗原水平及其活性升高有关。Objective To observe the relation of the chronobiology characteristic of acute myocardial infarction patients and thrombolytic therapy. Methods 80 acute myocardial infarction patients were selected and treated within 3 h.Patients were divided into two groups by disease time.In morning period group,there were 45 patients and in other period group,there were 35 patients.The recanalization rate and anticoagulation and fibrinolysis activity of the two groups were detected. Results The recanalization rate of a.m.group was lower than other times group（P0.05）.The level of PAI-1 in a.m.group was higher than other times group（P0.05）.There were no differences between other index（P0.05）.The level of PAI-1 for un-recanalization patients before and after thrombolytic therapy was higher than recanalization patients（P0.05）. Conclusions The effects of thrombolytic therapy on acute myocardial infarction patients are related to chronobiology characteristic.There is morning resistance phenomenon in thrombolytic therapy and it may be related to the level and activity of PAI-1.

关 键 词：急性心肌梗死 溶栓治疗 时间生物学 

分 类 号：R542.220.5[医药卫生—心血管疾病]