组织因子途径抑制物与冠状动脉性心脏病严重程度的相关性  

Correlation between tissue factor pathway inhibitor and coronary artery diseases

作　　者：彭娟[1] 樊冰[1] 马端[2] 邹云增[1] 葛均波[1] 

机构地区：[1]复旦大学附属中山医院心内科上海心血管病研究所,上海200032 [2]复旦大学上海医学院分子医学教育部重点实验室

出　　处：《上海医学》2013年第1期63-66,共4页Shanghai Medical Journal

摘　　要：目的测定不同程度冠状动脉性心脏病、冠状动脉内支架植入术前后患者的血浆组织因子途径抑制物(TFPI)水平,探讨其与冠状动脉性心脏病严重程度的相关性。方法收集120例有稳定性心绞痛(稳定性心绞痛组,30例)、不稳定性心绞痛(不稳定性心绞痛组,35例)和急性心肌梗死临床症状(急性心肌梗死组,55例)的冠状动脉性心脏病患者,按治疗常规予以药物、冠状动脉造影和介入治疗。经冠状动脉造影排除冠状动脉性心脏病的住院患者入选对照1组。所有患者在冠状动脉造影前取外周动脉血,行冠状动脉内支架植入术的患者在支架植入术前、术后即刻在冠状动脉窦取动脉血。采用酶联免疫吸附试验法(ELISA)检测TFPI水平。结果将不稳定性心绞痛组、急性心肌梗死组合并为急性冠状动脉综合征组,对照1组和稳定性心绞痛组合并为对照2组。急性冠状动脉综合征组的外周动脉血TFPI水平为(0.404±0.178)ng/mL,显著低于对照2组的[(0.517±0.256)ng/mL,P<0.05]。冠状动脉内支架植入前的TFPI水平为(0.382±0.140)ng/mL,与支架植入后[(0.389±0.170)ng/mL]的差异无统计学意义(P>0.05)。结论急性冠状动脉综合征患者的TFPI水平降低,提示体内组织因子介导的凝血途径异常。TFPI可能有助于冠状动脉性心脏病病情程度判断。Objective To determine the level of tissue factor pathway inhibitor （TFPI） in the patients with various coronary heart diseases and the changes of TFPI before and after stent implantation, and to explore the correlation between TFPI and coronary artery disease. Methods Totally 120 patients with coronary heart diseases （stable angina pectoris in 30, unstable angina pectoris in 35, acute myocardial infarction in 55） were enrolled in this study. All the patients received medications, coronary angiography and interventional therapy. Twenty-one patients without coronary heart diseases confirmed by angiography were taken as controls. Blood samples were taken from peripheral artery before angiography, and from coronary sinus before and immediately after stent implantation. TFPI concentrations were tested with enzyme-linked immunosorbent assay （ELISA）. Results TFPI levels in peripheral artery in the patients with acute coronary syndrome （unstable angina pectoris and acute myocardial infarction） were significantly lower than those in the patients with stable angina pectoris and without coronary heart diseases （[0. 404 ± 0. 178] ng/mL vs. [0.517 ± 0. 256] ng/mL, P〈0.05）. There was no significant difference in TFPI levels before and after stent implantation （[0. 382 ± 0. 140] ng/mL vs. [0. 389 ±0. 170] ng/mL, P〉0.05）. Conclusion The decrease of TFPI levels in patients with acute coronary syndrome suggests abnormalities in tissue factor-mediated coagulation in vivo. TFPI may help understand the severity of coronary heart disease.

关 键 词：组织因子途径抑制物 冠状动脉性心脏病 支架 冠状动脉窦 

分 类 号：R541.4[医药卫生—心血管疾病]