摘要
经冠状动脉造影确诊的冠心病（ＣＨＤ）患者１８例，对照组１１例，采用平板运动试验诱发急性心肌缺血，检测运动前后纤溶功能的改变。结果表明：①ＣＨＤ患者运动试验阳性亚组（１２例）及其中有运动诱发胸痛者运动前或运动后的血浆纤维蛋白原（Ｆｇ）、纤溶酶原激活剂抑制物（ＰＡＩ）活性水平均显著高于相应的阴性亚组、对照组及无胸痛者，并且其ＰＡＩ活性约高出对照组基础水平１倍以上；②ＣＨＤ患者运动试验阴性亚组运动前或运动后的血浆ＰＡＩ活性及运动后血浆Ｆｇ水平均高于对照组基础水平。本研究提示，ＣＨＤ患者纤溶系统存在严重缺陷，其基础水平纤溶活性显著降低（特别是血浆ＰＡＩ活性显著增高）者易在剧烈活动因素诱发下发作急性心肌缺血和（或）心绞痛；平板运动试验结合Ｆｇ、组织型纤溶酶原激活剂及ＰＡＩ的检测可能有助于对ＣＨＤ诊断时的参考。
Changes of fibrinolytic activity during exercise in 18 patients with coronary heart disease(CHD group) documented by coronary angiography and 11 healthy subjects(control group) were studied. All of the subjects underwent a symptom-limited multistage submaximal treadmill exercise test according to 'Bruce programme'.In tread-mill exercise test,12 of the 18 patients with CHD were positive,6 of the 18 patients and 11 healthy subjects were negative. During exercise,6 of the 12 patients with test positive had attacks of angina pectoris. The results were as follows:①Plasma fibrinogen(Fg) and PAI activity levels before and after exercise in the test positive subgroup or in exercise induced chest pain subgroup were remarkably higher than in the test negative subgroup, control group, or no chest pain subgroup(p<0.01 or p<0.05).The levels of plasma PAI activity in the patients were about twice as high as in controls.②Plasma PAI activity before and after exercise, and plasma Fg levels after exercise in CHD patients with test negative were obviously higher than in controls(p<0.01 or p<0.05).The study suggests that the fibrinolytic system in CHD patients is seriously defective, i. e.with very low fibrinolytic activity levels and remarkably increased plasma PAI activity which could easily induce acute myocardial ischemia and/or angina pectoris by exercise, and that increased plasma PAI activity in CHD patients may be a sensitive indicator of acute myocardial ischemia. Testing of fibrinolytic activity during treadmill exercise test might have an inferable value in the diagnosis of CHD.
出处
《中国循环杂志》
CSCD
1995年第2期72-74,共3页
Chinese Circulation Journal
关键词
冠心病
急性
心肌缺血
平板运动试验
纤溶活性
Coronary heart disease
Acute myocardial ischemiai
Treadmill exercise test
Fibrinolytic activity
