论文部分内容阅读
目的:对急性冠脉综合征(ACS)患者用药前后血小板激活复合物-1(PAC-1)及血浆组织纤溶酶原激活物抑制剂-1(PAI-1)、血浆组织纤溶酶原激活物(T-PA)的检测,判断PAC-1是否可作为ACS病情监测的有效指标。方法:选取2008年1月至2008年12月入院治疗的ACS患者共60例,根据不稳定性心绞痛(UAP)和急性心肌梗死(AMI)的诊断标准设立为UAP组30例,AMI组30例,并设立对照组30例,分别测定PAC-1表达率、PAI-1与T-PA的含量测定,比较3组间PAC-1、PAI-1与T-PA含量的差异,同时在ACS患者给予常规药物治疗的基础上,观察患者治疗前及治疗后的取血时间点PAC-1、PAI-1与T-PA含量的变化,比较PAC-1、PAI-1与T-PA的变化情况。结果:①治疗前,ACS患者PAC-1的表达率及PAI-1含量、T-PA含量均高于对照组(P<0.01),其中AMI组PAI-1及PAC-1的表达率水平明显高于UAP组(P<0.05),而T-PA差异无统计学意义(P<0.05);②治疗后UAP氯吡格雷常规剂量组及常规治疗组各指标仍高于对照组(P<0.05);两亚组治疗后与治疗前比较,血PAC-1表达率、PAI-1含量有显著性降低,T-PA含量显著性升高(P<0.05);治疗后两亚组组间比较,氯吡格雷常规剂量组血PAC-1表达率、PAI-1含量降低更显著,T-PA含量显著性升高,组间有显著差异(P<0.05);③AMI三联组患者治疗后与治疗前比较血PAC-1表达率、PAI-1含量均显著性降低,T-PA含量显著性升高(P<0.05);④ACS患者治疗后各指标仍高于对照组,有显著性差异(P<0.05)。结论:①血小板膜糖蛋白Ⅱb/Ⅲa复合物纤维蛋白原受体PAC-1可作为冠心病患者病情检测的灵敏指标;②T-PA/PAI-1可作为反映冠心病患者内源性纤溶系统活性的有效指标;③氯吡格雷起效迅速,对急性冠脉综合征患者可显著抑制血小板活化,降低纤溶抑制系统活性。
Objective: To investigate the effects of PAC-1 and PAI-1 on plasma levels of plasminogen activator inhibitor-1 (PAI-1) in patients with acute coronary syndrome (ACS) Activator (T-PA) test to determine whether PAC-1 can be used as a valid indicator of ACS condition monitoring. Methods: A total of 60 ACS patients admitted to hospital from January 2008 to December 2008 were enrolled in this study. According to the diagnostic criteria of UAP and AMI, 30 patients with UAP and 30 patients with AMI , And the control group of 30 patients were established. The expression of PAC-1 and the contents of PAI-1 and T-PA were determined. The differences of PAC-1, PAI-1 and T-PA in the three groups were compared. The changes of PAC-1, PAI-1 and T-PA in patients before and after the treatment were observed on the basis of routine drug treatment. The changes of PAC-1, PAI-1 and T-PA were compared . Results: ① Before treatment, the expression of PAC-1 and the content of PAI-1 and T-PA in ACS patients were higher than those in control group (P <0.01). The expression of PAC-1 and PAC-1 in ACS patients were significantly higher (P <0.05); ② After treatment, the indexes of UAP group and conventional treatment group were still higher than that of the control group (P <0.05) ). After treatment, the expression of PAC-1 and the content of PAI-1 in the two subgroups were significantly decreased and T-PA content was significantly increased (P <0.05) after treatment compared with those before treatment (P <0.05); (3) The expression of PAC-1 and the expression of PAI-1 in the conventional dose of clopidogrel group were significantly lower than those in the conventional dose group (P <0.05) The levels of PAC-1 and PAI-1 were significantly decreased and the content of T-PA was significantly increased (P <0.05) before treatment; ④The indexes of ACS patients were still higher than those of the control group after treatment (P <0.05). Conclusion: Platelet membrane glycoprotein Ⅱb / Ⅲa complex fibrinogen receptor PAC-1 can be used as a sensitive indicator of coronary heart disease detection; ② T-PA / PAI-1 can be used as a reflection of endogenous fibrinolytic system in patients with coronary heart disease Activity of the effective indicators; ③ clopidogrel rapid onset of acute coronary syndrome patients can significantly inhibit platelet activation, reduce fibrinolytic system activity.