不稳定心绞痛血凝/纤溶系统变化临床研究  

A study on the change of coagulation and fibrinolytic systems in patients with unstable angina pectoris

作　　者：崔家玉[1] 高慧芳[1] 王丽萍[1] 高雪杉[1] 郑洪泽[2] 

机构地区：[1]山东省千佛山医院,250014 [2]山东省滨州市人民医院心内科,256610

出　　处：《实用心脑肺血管病杂志》2003年第1期8-11,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的　探讨对强化药物治疗反应不同的两组不稳定性心绞痛病人血凝及纤溶指标变化规律 ,及其在不稳定性心绞痛危险度分层中的意义。　方法　不稳定心绞痛病人共 16 3例作为治疗组 (UA组 ) ,依强化治疗72小时病情是否得到良好控制分为UAA、UAB两个亚组 ,另 2 0例稳定性心绞痛为对照组SA组 ,所有病例均进行凝血酶原时间 (PT)、分凝血活酶时间 (APTT)、纤维蛋白原 (FG)、D 二聚体 (DD)测定 ,并于第 3天、5天、7天、10天UA再重复测定上述指标。随访 90天内被迫采取心脏介入治疗、发生心肌梗死及死亡情况。　结果　临床首次检测结果均提示PT、APTT在UAA、UAB与SA间无差异、也无预后意义 (P >0 0 5 ) ,UAA组FG血液浓度水平于病程第五天达高峰后迅速下降 ,而DD血液浓度水平于第三天后开始逐步下降 ;UAB组则FG、DD血液浓度水平至病程第十天则仍然保持它们在第 5天及第 3天的高峰水平 ,UAA、UAB两组病人的短期预后亦有明显差异 (P <0 0 5 )。　结论　DD、FG血液浓度水平在起病后前十天保持高水平是难治性不稳定性心绞痛的血液学标志 ,同时也是提示病人近期预后较差的预报因子。Objective To investigate the clinical significance on the change of coagulation and fibrinolytic systems in patients with unstable angina pectoris. Methods There were 163 patients with unstable angina pectoris as the observed group (US group),20 patients with stable angina pectoris as the control group(SA group).The active partial thromboplastin times(APTT),prothrombin time(PT),Fribrinogen(FG),D-dimer(DD) were tested in all patients for ten times(ten days).After 90 days,according to the result of follow-up survey,the observed group was divided into two subgroups:one was favourable prognosis group(UAA),other one was unfavorable prognosis group(UAB). Results At the first time(the first day) all the test were no difference in UA group or SA group,but the concentration of FG and DD in US group was higher than in SA group(P<0.05),in UAA and UAB group.Their concentration continued increase and at the third or fifth time reached the high peak,whether FG or DD the concentration was higher in UAB group(P<0.05). Conclusion The high plasma concentration of FG and DD in patients with unstable angina pectoris might show the unfavorable prognosis,specially that the concentration continued increase.

关 键 词：不稳定性心绞痛 血凝系统 纤溶系统 纤维蛋白原 D-二聚体 

分 类 号：R541.4[医药卫生—心血管疾病]