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目的:检测急性冠脉综合征患者外周血抗凝血酶和凝血指标并评价临床意义。方法:急性冠脉综合征患者102例为ACS组,其中急性心肌梗死(AMI)49例,不稳定型心绞痛(UA)53例。测定凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、抗凝血酶活性(AT:A)、D-二聚体(D-D)。稳定型心绞痛组(SA)66例,正常人50例为对照组。结果:ACS组AT:A明显低于SA组及对照组,PT,APTT明显缩短、FIB及D-D明显升高(均P<0.01)。SA组与对照组各指标差别无统计学意义。AMI组与UA组比较:AT:A降低、PT和APTT缩短、FIB和D-D增高(P<0.01)。ACS组AT:A与FIB、D-D相关系数分别为r2=0.4751和r2=0.5612,P<0.05,有一定相关性。结论:抗凝血酶及凝血指标能及时反映ACS患者体内凝血和抗凝系统失衡情况,可作为有效预测急性心血管事件发生及危险分层的临床指标。
Objective: To detect the antithrombin and coagulation indexes of peripheral blood in patients with acute coronary syndrome and to evaluate the clinical significance. Methods: A total of 102 patients with acute coronary syndrome (ACS) were enrolled as ACS group, including 49 AMI patients and 53 unstable angina pectoris patients. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), antithrombin activity (AT: A) and D-dimer (D-D) were measured. 66 cases of stable angina pectoris group (SA), 50 cases of normal control group. Results: The AT: A in ACS group was significantly lower than that in SA group and control group. PT and APTT were significantly shortened and FIB and D-D were significantly increased (all P <0.01). There was no significant difference between each index of SA group and control group. AMI group and UA group: AT: A decreased, PT and APTT shortened, FIB and D-D increased (P <0.01). ACS group AT: A and FIB, D-D correlation coefficients were r2 = 0.4751 and r2 = 0.5612, P <0.05, a certain correlation. Conclusion: Antithrombin and coagulation indexes can reflect the imbalance of coagulation and anticoagulation system in patients with ACS, and can be used as a clinical index to effectively predict the occurrence of acute cardiovascular events and risk stratification.