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目的:探讨冠心病患者凝血、抗凝与纤溶功能的改变及临床意义。方法:应用发色底物法及胶乳增强的免疫比浊法分别测定不同类型的冠心病患者160例及健康对照者80例血浆抗凝血酶(AT)、组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活抑制物-1(PAI-1)及D-二聚体(D-dimer)的活性或含量水平,并进行比较分析。结果:与对照组比较,冠心病患者AT、t-PA的活性显著降低,PAI-1、D-dimer的活性或含量水平显著增高(P<0.05或P<0.01);与稳定性心绞痛患者组比较,不稳定性心绞痛组及心肌梗死组AT、t-PA、PAI-1、D-dimer的活性或含量水平亦有显著性改变(P<0.05或P<0.01)。结论:冠心病患者特别是不稳定性心绞痛及心肌梗死患者存在高凝状态及纤溶活性亢进。
Objective: To investigate the changes and clinical significance of coagulation, anticoagulation and fibrinolysis in patients with coronary heart disease. Methods: The antithrombin (AT) and tissue plasminogen activator (T) of 160 patients with different types of coronary heart disease (CHD) and 80 healthy controls were detected by chromogenic substrate method and latex-enhanced immunoturbidimetry, respectively. t-PA), plasminogen activator inhibitor-1 (PAI-1) and D-dimer were measured and compared. Results: Compared with the control group, the activities of AT and t-PA in patients with coronary heart disease were significantly decreased, and the activities or levels of PAI-1 and D-dimer were significantly increased (P <0.05 or P <0.01) The levels of AT, t-PA, PAI-1, D-dimer in patients with unstable angina pectoris and myocardial infarction were also significantly different (P <0.05 or P <0.01). Conclusion: Patients with coronary heart disease, especially unstable angina pectoris and myocardial infarction, have hypercoagulable state and hyperfibrinolytic activity.