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目的 观察急性缺血性心脑血管疾病患者发作期间组织因子途径(TFP)各指标及比值的变化.方法 血浆中组织因子(TFAg)、组织因子途径抑制物(TFPI)、激活的Ⅶ(FⅦa)及凝血因子Ⅶ抗原(FⅦAg)检测采用ELISA法;凝血因子Ⅶ促凝活性(FⅦ∶C)测定采用一期凝固法;观察对象包括急性心肌梗死(AMI) 79例、急性缺血性脑卒中(AIS) 54例和健康体检者165例.结果 与对照组比较,AMI及AIS组血浆TF、TFPI两因子及其各比值分析除TF/t-TFPI、TF/fl-TFPI外,余各指标差异均有统计学意义(P＜0.05);FⅦ检测显示,在AMI组FⅦ∶C、FⅦa、FⅦ∶C/FⅦAg和FⅦa/FⅦAg比值与对照组比较有显著性差异(P＜0.05);在AIS组为FⅦ∶C、FⅦ∶C/FⅦAg和FⅦa/FⅦAg高于对照组,FⅦa/FⅦ∶C低于对照组和AMI组,而FⅦa又低于AMI组.结论 除FⅦa/FⅦ:C外,TFP其余因子的变化趋势在AMI和AIS患者中是一致的.提示运用比值的测定可能更敏感,更可靠的评估凝血过程的发生.“,”Objective To observe the changes of tissue factor pathway and theri ratio during the attack of acute ischemic cerebrocardiac disease.Methods Plasma tissue factor (TF),TF pathway inhibitor (TFPI) and FⅦ antigen(FⅦAg) and activated FⅦ(FⅦa) were measured with enzyme linked immunoabsorbent assay (ELISA);Plasma Ⅶ coagulation activity (F Ⅶ ∶ C) was observed in the one-stage clotting assay.79 patients with acute myocardial infarction (AMI),54 patients with acute ischemic stroke (AIS)and 165 healthy volunteers were observed.Results ①There were significant differences in TF,total-TFPI (t-TFPI),free-TFPI (fl-TFPI),treat-TFPI (tr-TFPI)level and the ratio between the three parameters of TFPI between the patients with AMI,AIS and healthy groups (P ＜ 0.05,P ＜ 0.01).Although the TF/t-TFPI,TF/fl-TFPI ratio during the acute stage were higher in AMI and AIS groups than that in normal controls,but no insignificant difference(P ＞0.05).② In AMI group,FⅦ ∶C,FⅦa and the ratio of FⅦ ∶C/FⅦAg and FⅦa/FⅦAg were significantly higher than normal controls (P ＜ 0.05);in AIS group,F Ⅶ ∶ C and F Ⅶ ∶ C/F Ⅶ Ag and F Ⅶ a/F Ⅶ Ag were significantly higher(P ＜ 0.05),while F Ⅶ a/F Ⅶ ∶ C was significantly lower than that in normal controls and AMI group (P ＜ 0.05),F Ⅶa was lower than that in AMI group (P ＜ 0.05).Conclusion Except TF activity,the tendency of the changes of TFP is consistent in both (AMI and AIS) groups.It may be more sensitive and reliable to use the ratios to evaluate the initiation status of coagulation.