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目的：探讨急性心肌梗死（ＡＭＩ）患者尿纤维蛋白肽Ａ（ＦＰＡ）和血浆Ｄ－二聚体（Ｄ－ｄｉｍｅｒ）的动态变化及其临床意义。方法：收集３０例ＡＭＩ患者入院后１～３ｄ的晨尿及血标本进行ＦＰＡ和Ｄ－ｄｉｍｅｒ水平动态检测，并与正常值进行比较。结果：①ＡＭＩ患者尿ＦＰＡ水平均明显高于正常值（Ｐ＜０．００１），第１天最高；②ＡＭＩ患者血浆Ｄ－ｄｉｍｅｒ水平均明显高于正常值且逐渐升高，第３天达最高值；③溶栓治疗后，血浆Ｄ－ｄｉｍｅｒ最高值提前至发病后第２天。结论：①尿ＦＰＡ是反映体内凝血系统激活状态及血栓形成的早期敏感指标之一，可作为ＡＭＩ早期诊断常规检查项目；②血浆Ｄ－ｄｉｍｅｒ反映体内高凝状态和血栓形成。溶栓治疗后峰值提前，可作为ＡＭＩ早期诊断及判断溶栓疗效的参考指标。
Objective: To investigate the dynamic changes of urinary fibrinolytic peptide A (FPA) and plasma D-dimer in patients with acute myocardial infarction (AMI) and its clinical significance. Methods: The morning urine and blood samples were collected from 30 patients with AMI 1 ~ 3 days after admission for the dynamic detection of FPA and D-dimer levels and compared with normal values. Results: (1) Urinary FPA levels in patients with AMI were significantly higher than those in normal patients (P <0.001), and were highest on the first day; (2) Plasma D-dimer levels in AMI patients were significantly higher than normal and gradually increased, reaching the highest values on the third day ; ③ thrombolytic therapy, the highest plasma D-dimer early to 2 days after onset. Conclusions: ① Urine FPA is one of the early sensitive indicators reflecting the activation status of the coagulation system and thrombosis in vivo, which can be used as an early diagnostic routine for AMI. ② Plasma D-dimer reflects hypercoagulable state and thrombosis in vivo. Thrombolytic therapy after the peak early, AMI can be used as early diagnosis and evaluation of thrombolytic efficacy of the reference index.