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为研究急性心肌梗死（ＡＭＩ）溶栓治疗对纤溶系统的影响，对３７例ＡＭＩ患者入院即刻、溶栓治疗（或非溶栓组一般治疗）后１、６、２４ｈ，第２、３、５、１５ｄ测周围静脉血中Ｄ－二聚体（ＤＤ）水平、纤溶酶原激活物活性（ＰＡＡ）、纤溶酶原激活抑制物活性（ＰＡＩＡ）、纤溶酶原活性（ＰＬＧＡ），进行动态观察，并分析其与梗死相关冠脉（ＩＲＡ）再通的关系。结果表明，ＡＭＩ组与正常组相比，血浆ＤＤ水平显著升高（Ｐ＜０．０１），ＰＡＡ无变化，ＰＡＩＡ显著升高（Ｐ＜０．０１），ＰＬＧＡ亦显著升高（Ｐ＜０．０５）；溶栓治疗后，上述指标较溶栓前差异非常显著（Ｐ＜０．００１）；溶栓治疗后ＩＲＡ未通组与再通组相比，溶栓后６、２４ｈＰＡＩＡ前者较后者显著升高（Ｐ＜０．０５），ＰＡＡ、ＰＬＧＡ及ＤＤ水平无显著差异（Ｐ＞０．０５）。提示ＰＡＩ在ＡＭＩ血栓形成中具有重要的病理意义，部分血栓之所以出现溶解抵抗可能与溶栓后血浆中ＰＡＩ大幅度回跳有关，而ＩＲＡ再通组与未通组血浆ＤＤ水平无显著差异，表明ＤＤ不能作为监测ＩＲＡ是否再通的指标。
To investigate the effect of thrombolytic therapy on fibrinolytic system in patients with acute myocardial infarction (AMI), 37 patients with acute myocardial infarction (AMI) were enrolled immediately, 1, 6, 24 hours after thrombolytic therapy (or general treatment without thrombolysis group) The levels of D-dimer (DD), plasminogen activator (PAA), plasminogen activator inhibitor (PAIA), plasminogen activator (PLGA) Dynamic observations were performed and their relationship with recanalization of infarct-related coronary artery (IRA) was analyzed. The results showed that the level of plasma DD was significantly increased in AMI group compared with that in normal group (P <0.01), PAA was not changed, PAIA was significantly increased (P <0.01), PLGA was also significantly increased (P <0 .05). After thrombolytic therapy, the above indexes were significantly different from those before thrombolysis (P <0.001). Compared with recanalization group after thrombolytic therapy, (P <0.05). There was no significant difference between the levels of PAA, PLGA and DD (P> 0.05). These results suggest that PAI plays an important pathological role in the thrombosis of AMI. The reason why partial thrombolysis may be related to the rebound of PAI in thrombolysis after thrombolytic therapy, but there is no significant difference in plasma DD level between IRA recanalization group and control group, DD can not be used as an indicator of whether the IRA is recanalized.