组织因子及其抑制物在急性冠脉血栓性事件中的表达  

The role of Tissue Factor and Tissue Factor Pathway Inhibitor in Patiens with an Acute Coronary Syndrome

作　　者：王渊铭[1] 马瑾[1] 陈德[1] 黄晴[1] 王萍[1] 戴月[1] 王蕊[1] 

机构地区：[1]上海市同济大学附属杨浦医院,上海200090

出　　处：《血栓与止血学》2015年第3期136-138,143,共4页Chinese Journal of Thrombosis and Hemostasis

基　　金：上海市卫生局青年科研项目基金资助(20124y103);上海市自然科学基金资助项目(13ZR1439000)

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者血浆组织因子(TF)、组织因子途径抑制物(TFPI)水平及临床意义。方法利用ELISA法检测急性心肌梗死(AMI)59例﹑不稳定心绞痛(UA)42例;并与同期确诊的48例稳定心绞痛(SA)和体检正常人50例的TF﹑TFPI水平进行比较分析。结果 1 AMI组和UA组血浆中TF含量明显高于SA组和体检正常组(P<0.05);AMI组和UA组总TFPI(t-TFPI)、全长TFPI(fl-TFPI)明显高于SA和体检正常组;截短TFPI(tr-TFPI)在AMI组明显低于SA和体检正常组(P<0.01);而UA组仅低于体检正常组,与SA组比较差异无显著性(P>0.05);2行TFP比值分析在AMI及UA组TF/tr-TFPI明显高于SA和体检正常组,尤以AMI组更为突出,有明显统计学差异(P<0.01)。结论急性冠状动脉血栓性事件在发生过程中血浆TF与tr-TFPI的平衡起着关键作用。Objective To explore the levels of plasma tissue factor（TF） and tissue factor pathway in- hibitor（ TFPI ）and clinical significance in patients with Acute Coronary Syndrome （ACS）. Methods The plasma levels of TF and TFPI were detected in 59 patients with acute myocardial infarction （AMI） ,42 patients with unstable angina pectoris （UA） , 48 patients with stable angina pectoris （SA） and 50 controls by ELISA methods. Results 1. The plasma levels of TF were significantly higher in patients with AMI （248.80 ± 106. 45 ng/L） and UA（246.60 ± 104.45 ng/L） than levels in patients with SA（ 194.41 ± 89.86 ng/L） and con- trols（ 199.41 ±97.36 ng/Lp 〈0.05 ）. There was no difference between the AMI and UA（p 〉0.05 ）. 2. The plasma levels of t-TFPI,fl-TFPI were significantly higher both in the patients with AMI（99.30 ± 21.17 g/L, 53.70 ± 21.10 g/L）and UA（97.50 ± 22.60 g/L ;51.60 ± 15.90 g/L）than in the patients with SA （83.13 ± 12.85 g/L;30.75 ±7.22 g/L）and controls（86.71 ± 17.22 g/L;26.02 ± 6.79 g/L）. While the level of tr- TFPI was significantly lower in the patients with AMI（45.60 ± 13.82 g/L）than in the patients with SA（52. 38 ± 13.01 g/L） and controls（60.69 ± 19.56 g/L） （ P 〈 0.01 ）. The level of tr-TFPI was only significantly lower in UA（46.90 ± 17.52 g/L）. UA group was lower than that of the SA ,hut no significant difference（ p 〉 0.05）. 2. TF/tr-TFPI ratio in AMI and UA were higher than those in SA and healthy people. There was signif- icant difference in AMI. （P 〈 0.01 ）o Conclusion It suggests that the balance between the TF and tr-TFPI play an important role in the pathogenesis of acute coronary arterial thrombotic events.

关 键 词：急性心肌梗死 不稳定心绞痛 组织因子 组织因子途径抑制物 

分 类 号：R543.3[医药卫生—心血管疾病]