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目的：探讨急性心肌梗死（AMI）患者凝血及纤溶系统变化及其临床意义。方法：对51例AMI患者（37例溶栓治疗，14例未溶栓治疗）在治疗前，治疗后4h、12h、24h、48h、1周测定凝血酶原时间（PT）、活化的部分凝血活酶时间（APTT）、纤溶酶原（PCG）活性、α2抗纤溶酶（α2AP）活性、纤维蛋白原（Fg）含量、D二聚体（D-Dimer）含量。结果：AMI溶栓治疗后4h，PCG、α2AP活性及Fg含量大幅度降低，D－Dimer含量明显增高，PT、APTT明显延长；溶栓后48h各项指标已分别恢复至溶栓前水平。结论：溶栓治疗可使AMI患者凝血活性明显减弱，纤溶活性明显增强，但溶栓剂的作用时限短暂，监测PT、APTT、Fg等指标对预防出血有一定意义。
Objective: To investigate the changes of coagulation and fibrinolysis system in patients with acute myocardial infarction (AMI) and its clinical significance. Methods: Thrombin time (PT), partial coagulation of activated blood were measured in 51 patients with AMI (37 thrombolytic therapy and 14 without thrombolysis) before treatment, 4h, 12h, 24h, 48h, (APTT), plasminogen (PCG) activity, α2 anti-plasmin (α2AP) activity, fibrinogen (Fg) content, and D-Dimer content. Results: The activities of PCG and α2AP and the contents of Fg in the AMI group were significantly decreased at 4 h after thrombolytic therapy. The content of D-Dimer was significantly increased and the PT and APTT were significantly prolonged. The indexes of 48 h after thrombolysis were restored to the level before the thrombolysis. Conclusion: Thrombolytic therapy can significantly reduce the clotting activity and fibrinolytic activity of AMI patients. However, the role of thrombolytic agents is short. The monitoring of PT, APTT, Fg and other indicators have some significance for the prevention of bleeding.