老年缺血性心脏病患者组织因子组织因子途径抑制物比值的变化及意义  

Changes of tissue factor, tissue factor pathway inhibitor ratio and its clinical significance in elderly patients with Ischemic heart disease

作　　者：王蕊[1] 马瑾[1] 陈德[1] 吴波[1] 王渊铭[1] 黄睛[1] 王萍[1] 戴月[1] 唐静辉[1] 

机构地区：[1]上海市同济大学附属杨浦医院心血管科,上海200090

出　　处：《中国急救医学》2016年第2期142-145,共4页Chinese Journal of Critical Care Medicine

基　　金：上海市自然科学基金资助项目（13ZR1439000）

摘　　要：目的观察老年缺血性心脏病（IHD）患者血浆组织因子（TF）、组织因子途径抑制物（TFPI）比值的变化及意义。方法选择IHD患者135例分为急性冠状动脉综合征（ACS）组97例[其中急性心肌梗死（AMI）组52例，不稳定型心绞痛（uA）组45例]；稳定型心绞痛（SA）组38例。正常对照组50例。采用ELISA法对所有纳入对象进行血浆TF、TFPI测定分析，比较各组间TF、TFPI比值表达的差异。结果AMI组和UA组TF、总TFPI（t-TFPI）[（263．14±114．98）ng／L和（102．07±27．43）μg/L]和[（258．73±110．12）ng／L和（96．86±23．08）μg/L]、全长TFPI（fl-TFP1）[（59．18±19．78）μg/L和（53．164-18．10）μg/L]及TF/截短TFPI（tr-TFPI）[（0．16±0．23）％和（0．59±0．24）％]、fl—TFPI／t-TFPI[（0．58±0．17）和O．55±O．15]的表达均较SA组[（201．41±101．36）ng／L、（87．02±17．85）μg/L、（36．44±10．21）μg/L、（0．42±0．15）％及0．42±0．10]和正常对照组[（192．89±91．36）ng／L、（86．98±21．34）μg/L、（31．62±11．23）μg/L、（0．35±0．14）％及0．36±0．11]明显增高（P〈0．05），tr-TFPI／t-TFPI、tr-TFPI／n-TFPI又明显低于SA组和正常对照组（P〈0．05）；tr-TFPI、TF／fl—TFPI在AMI组低于SA和正常对照组，而在UA组仅低于正常对照组（P〈0．05），与SA组比较差异无统计学意义（P〉0．05）。结论ACS患者发作期血液呈高凝状态，导致血栓形成风险增加；在血栓事件发生过程中血浆TF与tr—TFPI的平衡起着关键作用。Objective This study aims to investigate the changes of tissue factor pathway （TFP） parameters and their ratios in elderly patients with ischemic heart disease （II-ID）, and to understand its clinical significance. Methods TFP parameters of 50 healthy people and 38 patients with stable angina （SA）, 45 patients with unstable angina pectoris （UA）, 52 patients with acute myocardial infarction （AMI） were measured during the same time period by ELISA method. Results There were significant differences in tissue factor （TF）, total -TFPI （t - TFPI）, free -TFPI （fl - TFPI）, treat -TFPI （tr -TFPI） and the ratios of these parameters between AMI, UA group and SA, healthy control group （P 〈 0. 05 ）. Expressions of plasma levels of TF, t - TFPI, fl - TFPI and TF/tr - TFPI, tr - TFPI/fl - TFPI were significantly higher in ACS groups [ （263.14 ± 114. 98 ） ng/L, （ 102.07 ± 27.43 ） μg/L ] and [ （ 258.73 ± 110. 12 ） ng/L, （ 96. 86 ± 23.08）μg/L,（59. 18 ± 19. 78）μg/L, （53.16 ±18.10） μg/L], TF/tr - TFPI（0. 61 ±0. 23）%, （0.59 ± 0.24） %, fl - TFPI/t - TFPI （0. 58 ± 0. 17 ）, （ 0. 55 ± 0. 15 ） between AMI, UA group and S A, helthy control group（P 〈0.05）. [ SA （201.41 ± 101.36）ng/L, （87.02 ± 17.85） μg/L, （36.44 ±10.21） μg/L, （0. 42 ± 0.15）%, （0.42±0.10）];Control： （192.89 ±91.36）ng/L,（86.98 ±21.34）μg/L,（31.62±11.23）lag/L, （0. 35 ± 0. 14）%, （0. 36 ± 0. 11 ） however, the tr - TFPI/t - TFPI, tr - TFPI/fl - TFPI were significantly lower than those in SA and health control groups （P 〈0.05）. In AMI group, the level of tr-TFPI and ratio of TF/fl - TFPI were significantly lower than those in health control and SA groups （P 〈 0.05 ） ; while in UAgroup, they were only remarkably lower than those of health control group （P 〈0.05）, but not significant different compared with SA group （P 〉0.05）. Conclmion The blood is in a hypercoagnlabihty and the risk of thrombosis evidence

关 键 词：缺血性心脏病(IHD) 急性冠状动脉综合征(ACS) 组织因子(TF) 组织因子途径抑制物(TFPI) 比值 

分 类 号：R541.4[医药卫生—心血管疾病]