急性冠脉综合征患者血浆中凝血酶激活的纤溶抑制物变化

摘要

Objective To discuss the changes of the plasma thrombin activatable fibrinolysis inhibiton (TAFI:Ag and TAFI:A) levels in patients with acute coronary syndrome ( ACS). Methods There are 40 healthy adults as controls and 60 ACS patients in the study, all of the people were approved by coronary angiography ( CAG) . The plasma levels of TAFI: Ag and TAFI: A were examined respectively with enzyme linked immunoadsordent assay( ELISA) or chrimato-substrate assay( CSA) , then to compare the results between controls and patients. Results The mean of the plasma TAFI : Ag and TAFI:A for ACS patients is 95 ±34％ and 29. 2 ± 11. 2 μg/ml, and both of these variances are significant as compared with the controls ( P ＜ 0. 001 ) ; the level of plasma TAFI: Ag in myocardiac inparction(MI) group is little higher than that of the unstable angina ( UA) group,there is no significant,but the result of plasma TAFI : A is obviously statistical significance( P ＜0.05). Conclusion There is a higher level of plasma TAFI in ACS patients as compared with the controls;The result indicates that TAFI play a role in the procession of ACS. The genetic expression of TAFI : Ag in UA may be the same as that in MI, but the activation of TAFI: Ag is obviously enhanced,and this demonstrates that there may be a fibrinolytic inhibition in procession of MI.%目的 探讨急性冠脉综合征(ACS)患者血浆中TAFI:Ag和TAFI:A含量的变化.方法 分别应用ELISA法、发色底物法测定40例冠状动脉造影(CAG)正常者和60例经CAG证实的ACS患者血浆中TAFI:Ag、TAFI:A含量;并对该两组TAFI:Ag和TAFI:A含量进行对照分析.结果 ACS患者血浆中TAFI:Ag均值为95±34%,TAFI:A均值为29.2±11.2μg/ml,且均明显高于CAG正常者(P<0.001).亚组分析显示心肌梗死组中TAFI:Ag含量略高于心绞痛组但差异不明显(P>0.05),而TAFI:A含量则明显较高(P<0.05).结论 ACS患者血浆中TAFI:Ag和TAFI:A均显著增高,表明TAFI在ACS发病过程中起一定作用;TAFI:Ag在心绞痛和心肌梗死中的表达可能是一致的,但在心肌梗死患者中TAFI:Ag的激活程度却明显加强,提示心肌梗死患者发病过程中存在较明显的纤溶功能抑制.