经皮冠状动脉腔内成形术前后凝血功能的动态变化  

Serial Changes of the Coagulative Function before and after Percutaneous Transluminal Coronary Angioplasty

作　　者：张峻[1] 陈纪林[1] 赵秀文[1] 关婷[1] 吴永健[1] 袁晋青[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室,北京市100037

出　　处：《中国循环杂志》2001年第2期112-113,共2页Chinese Circulation Journal

摘　　要：目的：了解经皮冠状动脉腔内成形术（ＰＴＣＡ）前后凝血及纤溶系统的相应变化。 方法：选择行ＰＴＣＡ的患者２０例，于手术前１天、术后４、１２、２４、４８、７２小时和手术后第５天取血测定纤维蛋白肽Ａ（ＦＰＡ）、组织型纤溶酶原激活物（ｔＰＡ）活性、纤溶酶原激活物抑制剂－１（ＰＡＩ－１）活性。 结果：ＰＴＣＡ术后１２小时ＦＰＡ较术前增高（Ｐ＝０．０１），并于术后２４小时达到峰值（Ｐ＜０．０１），均有非常显著性差异。此后逐渐降低，于术后第５天恢复至术前水平；ＰＡＩ－ｌ活性、ｔＰＡ活性和ＰＡＩ－１／ｔＰＡ术前术后无明显变化。 结论：ＰＴＣＡ术后凝血系统被激活，应加强抗凝血酶的治疗。Objectives:To study the serial changes of coagulative function before and after percutaneous transluminal coronary angioplasty (PTCA ). Methods :Plasma fibrinopeptide A (FPA),the activity of tissue-type plasminogen activator(tPA) and plasminogen activator inhibitor-1(PAI-1) in patients undergoing PTCA were measured before and 4, 12, 24, 48, 72 hours and 5 days after angioplasty. Results:FPA levels were increased significantly 12 hours after PTCA and reached the peak 24 hours later. Then they were decreased gradually and went back to the levels before PTCA 5 days after the procedure. The activities of PAI-1,tPA and PAI-l/tPA after PTCA were not significantly different compared with the levels before the procedure. Conclusions:After PTCA,coagulation system was activated. Antithrombin treament should be enhanced.

关 键 词：血管成形术 经皮冠状动脉腔内成形术 凝血功能 纤维蛋白肽A类 冠心病 

分 类 号：R654.2[医药卫生—外科学] R541.4[医药卫生—临床医学]