摘要
目的 :探讨纤维蛋白溶解 (纤溶 )系统成分在冠状动脉腔内成形术 (PTCA)后再狭窄过程中的作用 ,明确纤溶功能与再狭窄的关系。方法 :因单支血管病变或多支血管病变仅有单支血管行择期 PTCA的 2 8例患者 ,男 2 3例 ,女 5例 ,平均年龄 (5 5 .8± 9.5 )岁 ,于手术后平均 (6 .4± 2 .4)个月进行冠状动脉 (冠脉 )造影随访。分别测定患者 PTCA术前 ,术后 1周 ,术后 3个月及冠脉造影随访前血浆中组织型纤溶酶原激活剂 (t PA) ,纤溶酶原激活剂抑制物 (PAI 1)和纤维蛋白原 (Fg)的水平。结果 :再狭窄组术后 1周、3个月的 t PA活性分别为 (1.86± 0 .5 8) k U/ L、(1.91± 0 .44 ) k U/ L,较术前 (2 .83± 0 .72 ) k U/ L 明显降低 (P均 <0 .0 5 ) ;再狭窄组术后 1周、3个月的 PAI 1活性分别为 (12 .37± 2 .33) k AU/ L、(12 .36± 2 .2 9) k AU/ L,较术前 (9.13±2 .14) k AU/ L显著升高 (P均 <0 .0 0 5 ) ,而且明显高于非再狭窄组〔分别为 (8.35± 2 .10 ) k AU/ L、(8.39±2 .74) k AU/ L,P均 <0 .0 5〕;术前、术后 Fg无明显差异。结论 :PTCA术后 1周～ 3个月纤溶功能受损影响血管损伤的修复 ,与再狭窄密切相关 。
Objective:To study the role of fibrinolytic components in the process of restenosis after percutaneous transluminal coronary angioplasty (PTCA).Methods:Twentyeight patients were included in the study who either suffered from singlevessel disease or multivessel disease with only one vessel undergone elective PTCA 〔23 male,5 female;age(55 8±9 5)years〕.Followup angiography was taken (6 4±2 4)months after coronary angioplasty.Blood samples were collected after 12hour fast four times in each patient,i.e.before angioplasty,1 week and 3 months after angioplasty,and before coronary angiography.The levels of tissue plasminogen activator (tPA),plasminogen activator inhibitor1(PAI1) and fibrinogen(Fg) were measured respectively.Results:The activities of tPA were (1 86±0 58)kU/L and (1 91±0 44)kU/L,respectively, in 1 week and 3 months after operation in patients with restenosis,which was significantly lower than that before PTCA 〔(2 83±0 72)kU/L,all P <0 05〕.At 1 week and 3 months after PTCA,activities of PAI1 were (12 37±2 33)kAU/L and (12 36±2 29)kAU/L,respectively,and they were significantly higher than that before PTCA 〔(9 13±2 14)kAU/L,all P <0 005〕,and those in patients without restenosis 〔(8 35± 2 10)kAU/L and (8 39±2 74)kAU/L,respectively,all P <0 05〕. No significant differences were found in Fg levels before and after PTCA.Conclusions:The results suggest that early impairment of fibrinolysis system (from 1 week to 3 months) after PTCA is associated with restenosis,affecting the repair process of vascular injury.Determination of the function of fibrinolytic system is helpful for the prediction of restenosis.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第11期650-652,共3页
Chinese Critical Care Medicine
基金
湖北省"九五"攻关课题部分!(No.96 2 P110 1)
关键词
冠状动脉腔内成形术
再狭窄
纤维蛋白溶解系统
percutaneous transluminal coronary angioplasty
restenosis
tissue plasminogen activator
plasminogen activator inhibitor1
fibrinogen
