摘要
观察４４例首次急性心肌梗塞（ＡＭＩ）患者的尿激酶（ＵＫ）静脉溶栓治疗前后血浆ＵＫ抗原、组织纤溶酶原激活物（ｔ－ＰＡ）抗原、纤溶酶原激活物（ＰＡ）活性、纤溶酶原激活物抑制物（ＰＡＩ）活性、纤溶酶活性和纤维蛋白原抗原的变化。结果显示：（１）ＵＫ静脉注射的作用持续时间较短，注射后１小时和５小时，分别有５３．２％和９３．７％的ＵＫ抗原从血浆中清除。（２）与治疗前相比，ＵＫ静注后ＰＡ和纤溶酶活性升高、ＰＡＩ活性降低，纠治了ＡＭＩ时纤溶系统的功能紊乱状况。但是，停止ＵＫ注射后即出现ＰＡＩ“反弹”现象，ＰＡ和纤溶酶活性随之降低，说明溶栓早期存在反常的高凝状态。（３）ＰＡＩ活性升高程度与左心室功能受损及ＡＭＩ病情程度有一定关系。以上各点均提示，溶栓早期辅助的抗凝治疗尤为重要。
Abstract Plasma urokinase(UK)antigen,tissue plasminogen activator (t-PA) antigen, plasminogen activator(PA)activity, plasminogen activator inhibiter (PAI) activity, plasmin activity and fibrinogen antigen Were measured before and after thrombolytic treatment with intravenous UK in 44 patients suffering from their first attack of acute myocardial infarction(AMI). The results showed that:(1)The action of intravenous UK lasted for only a short period of time,as 53.2% and 93.7% of UK antigen were cleared from the plasma 1 hour and 5 hours respectively after the completion of UK treatment.(2)Compared to pretreatment values,PA and plasmin activities increased; PAI activity decreased during treatment, indicating enhanced fibrinolytic activity following UK therapy. However,immediately after treatment PAI activity showed again an significant increase (PAI rebound phenomenon), suggesting the existence of an abnormal procoagulant state in the early stage of thrombolytic treatment.(3) The changes in PAI activity were correlated possibly with the degree of damage of the left ventricular function and the severity of AMI. it seems important that adjunctive anticoagulant therapy should be given in the early stage of thrombolytic therapy.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1994年第1期46-48,共3页
Chinese Journal of Cardiology
