血浆PAI-1和TAFI的变化对STEMI患者静脉溶栓治疗后血管再通的预测价值.pdfVIP

血浆PAI-1和TAFI的变化对STEMI患者静脉溶栓治疗后血管再通的预测价值 林珮仪 陈晓辉* 江慧琳 陈洁茹 周旭红 冯莹 目的：通过检测急性心肌梗死(AMI)患者静脉溶栓前、后2小时内血浆凝血 酶激活的纤溶抑制物（TAFI）和纤溶酶原激活物抑制剂-1（PAI-1）的含量，探 讨两者的变化是否对溶栓后血管再通具有预测价值。方法：2007年1月至2009年3 月期间收集16例急性ST段抬高心肌梗死(STEMI)患者溶栓前、后0.5h、1h、1.5h、 2h 的血浆标本，并以16名健康人作为对照组，用ELISA法测定血浆中TAFI和PAI-1 的含量。结果：1.与对照组相比，STEMI患者溶栓前的血浆PAI-1 水平显著升高 （ P＜0.01）；而TAFI活性与对照组相比无统计学差异。2. 与溶栓前相比，溶栓 后0.5h、1h、1.5h、2h 的血浆TAFI活性较溶栓前比较无统计学差异；溶栓后1.5h、 2h的血浆PAI-1显著升高（P＜0.01）。3. 溶栓后2h冠脉未通组PAI-1水平显著高 于再通组（P＜0.05）；而冠脉未通组和再通组TAFI活性差异无统计学意义。结 论：升高的血浆PAI-1在溶栓后2小时下降可能对溶栓后血管再通具预测价值， TAFI对血管再通不具预测价值。 关键词: 急性心肌梗死；ST 段抬高心肌梗死；溶栓治疗；重组组织型纤 溶酶原激活剂；凝血酶激活的纤溶抑制物；纤溶酶原激活物抑制剂-1；血管再通； 预测价值 The tendency of PAI-1 and TAFI levels in STEMI patients after thrombolytic treatment and its predictive value to restoration of coronary perfusion. LIN Pei-yi, CHEN Xiao-hui, JIANG Hui-lin，CHEN Jie-ru, ZHOU Xu-hong, FENG Ying. Emergency Department, The second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, China Abstract: Objectives To observe the tendency of the plasma concentration of Plasminogen activator inhibitor type-1(PAI-1) and thrombin activatable fibrinolysis inhibitor （TAFI ）before and after thrombolytic treatment of acute ST elevation myocardial infarction (STEMI) and to explore their recanalization predictive value of 基金号：广东省社会发展领域科技计划项目（2009B030801366）,广州市卫生局科研基金资助课题 （2008-YB-175） 作者单位：510260 广东省广州市，广州医学院第二附属医院急诊科 *通信作者：陈晓辉，Email: cxhgz168@126.com PAI-1 and TAFI for acute myocardial infarction patients with thrombolytic treatment.Methods Sixty patients who received thromobolytic treatment from January 2007 to March 2009 were prospectively recruited. The blood sample were collected within 2 hours of thromobolytic treatment( 0,0.5h, 1h, 1.5h and 2h). The plasma concentration of TAFI and PAI-1 were test by ELISA. 16 healthy people were recruited