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目的观察冠心病患者血浆组织因子(TF)、抗凝血酶复合物(TAT)的变化及其临床意义。方法回顾性分析72例临床确诊的冠心病患者,其中急性心肌梗死(AMI)29例、不稳定型心绞痛(UAP)25例、稳定型心绞痛(SAP)18例,并选15例体检健康者为对照组。血浆TF活性测定采用发色底物法,TAT含量测定采用ELISA法。结果(1)AMI组、对照组、SAP组比较,血浆TF分别为(2179+1236)、(1132+473)、(1147+480)ng/L,TAT分别为(257+108)、(73+63)与(71+53)ng/L,AMI组血浆TF活性与UAP组比较,差异无统计学意义(P>005),TAT含量较UAP组明显升高,差异有统计学意义(P<005);(2)UAP组血浆TF活性、TAT含量较健康对照组及SAP组明显升高,差异有统计学意义(P<005);(3)SAP组血浆TF活性、TAT含量与健康对照组比较,差异无统计学意义(P>005)。结论AMI、UAP患者存在异常激活的高凝状态,TF触发的外源性凝血途径,在冠状动脉血栓形成中发挥作用。
Objective To observe the changes of plasma Tissue Factor (TF) and Antithrombin Complex (TAT) in patients with coronary heart disease and its clinical significance. Methods A retrospective analysis of 72 clinically diagnosed patients with coronary heart disease, including 29 cases of acute myocardial infarction (AMI), unstable angina (UAP) 25 cases, 18 cases of stable angina pectoris (SAP), and selected 15 cases were healthy Control group. Plasma TF activity assay using chromogenic substrate method, TAT assay using ELISA method. Results (1) The levels of plasma TF were (2179 + 1236), (1132 + 473) and (1147 + 480) ng / L respectively in the AMI group, the control group and the SAP group +63) and (71 + 53) ng / L respectively. There was no significant difference in plasma TF activity between the AMI group and the UAP group (P> 0.05), and the TAT content was significantly higher than that of the UAP group (P (2) The activity of TF and the content of TAT in UAP group were significantly higher than those in healthy control group and SAP group (P <0.05); (3) The activity of TF, The control group, the difference was not statistically significant (P> 005). Conclusions There is an abnormally activated hypercoagulable state in AMI and UAP patients. TF-triggered extrinsic coagulation pathway plays a role in coronary thrombosis.