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目的:了解冠状动脉介入治疗对血液中组织因子(TF)和TF途径抑制物(TFPI)的影响,以及基础状态下TF、TFPI对急性冠状动脉综合征(ACS)患者预后的影响。方法:接受冠状动脉介入治疗(PCI)的ACS患者58例,分别检测基础状态,PCI后即刻、24和48h后血液中TF、TFPI的浓度;以基础状态TF、TFPI中位数为标准将患者分别分成临床特征相似的高浓度和低浓度2组,随访6~24个月,记录患者的主要不良心血管事件。结果:介入治疗后TF和TFPI均显著升高。基础状态,PCI后即刻、24和48h后血液中TF浓度分别为(1.52±0.82),(2.16±0.82),(2.47±0.55),(2.42±0.56)U/L;TFPI浓度分别为(0.18±0.05),(0.23±0.09),(0.16±0.02),(0.15±0.04)μg/L。TF和TFPI在介入后与基础状态时相比均差异有统计学意义(均P<0.05),TF的高浓度维持时间较长。TF和TFPI的高浓度和低浓度组患者发生的主要不良心血管事件均差异无统计学意义。结论:PCI可以使血液中TF和TFPI升高;基础状态TF和TFPI浓度与患者的预后无关。
Objective: To investigate the effect of percutaneous coronary intervention (TACE) on TF and TF pathway inhibitor (TFPI) in blood and the effect of TF and TFPI on the prognosis of patients with acute coronary syndrome (ACS). Methods: Fifty-eight ACS patients undergoing coronary intervention (PCI) were enrolled in this study. The concentrations of TF and TFPI in the blood were measured at baseline, immediately after PCI, and 24 and 48 hours after PCI respectively. The patients were divided into two groups according to the median TF and TFPI The patients were divided into two groups: high concentration and low concentration with similar clinical features. The patients were followed up for 6-24 months and the main adverse cardiovascular events were recorded. Results: TF and TFPI were significantly increased after interventional therapy. The basal state, the level of TF in the blood at 24 and 48 hours after PCI were (1.52 ± 0.82), (2.16 ± 0.82), (2.47 ± 0.55) and (2.42 ± 0.56) U / ± 0.05), (0.23 ± 0.09), (0.16 ± 0.02) and (0.15 ± 0.04) μg / L, respectively. TF and TFPI after intervention compared with the basal state were significantly different (all P <0.05), TF high concentrations of maintenance time longer. There was no significant difference in the major adverse cardiovascular events between high and low concentrations of TF and TFPI patients. Conclusion: PCI can increase TF and TFPI in blood. The basal TF and TFPI concentrations have no relation with the prognosis of patients.