现代中西医结合杂志
現代中西醫結閤雜誌
현대중서의결합잡지
MODERN JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE
2015年
5期
463-465
,共3页
急性心肌梗死%经皮冠状动脉成形术%无复流%组织因子%组织因子途径抑制物
急性心肌梗死%經皮冠狀動脈成形術%無複流%組織因子%組織因子途徑抑製物
급성심기경사%경피관상동맥성형술%무복류%조직인자%조직인자도경억제물
acute myocardial infarction%percutaneous coronary angioplasty%no reflow%tissue factor%tissue factor path-way inhibitor
目的：通过测定急性心肌梗死（AMI）患者的血浆组织因子（TF）、组织因子途径抑制物（ TFPI）水平在直接经皮冠状动脉成形术（ PCI）前后的变化，研究两者与直接介入后无复流的关系。方法选择急诊行PCI的AMI患者53例，用ELISA法检测患者PCI术前、术后即刻、术后24 h外周静脉血TF、TFPI水平。根据有无复流分为无复流组与再灌流组，比较2组不同时点TF、TFPI水平的变化。结果 PCI前、PCI后即刻、PCI后24 h无复流组血浆TF、TFPI水平均明显高于再灌流组（ P均＜0．01）；PCI后即刻，2组TF水平均较术前明显升高（P均＜0．01）；PCI后24 h，TF水平无复流组比术前高（P＜0．05），再灌流组与术前比较差异无统计学意义（ P＞0．05）； PCI前后2组TFPI 水平比较差异均无统计学意义（ P均＞0.05）。结论 AMI患者直接进行PCI手术，发生无复流现象与血浆TF水平呈正相关，TFPI具有阻止血栓形成的作用，也可防治无复流现象。
目的：通過測定急性心肌梗死（AMI）患者的血漿組織因子（TF）、組織因子途徑抑製物（ TFPI）水平在直接經皮冠狀動脈成形術（ PCI）前後的變化，研究兩者與直接介入後無複流的關繫。方法選擇急診行PCI的AMI患者53例，用ELISA法檢測患者PCI術前、術後即刻、術後24 h外週靜脈血TF、TFPI水平。根據有無複流分為無複流組與再灌流組，比較2組不同時點TF、TFPI水平的變化。結果 PCI前、PCI後即刻、PCI後24 h無複流組血漿TF、TFPI水平均明顯高于再灌流組（ P均＜0．01）；PCI後即刻，2組TF水平均較術前明顯升高（P均＜0．01）；PCI後24 h，TF水平無複流組比術前高（P＜0．05），再灌流組與術前比較差異無統計學意義（ P＞0．05）； PCI前後2組TFPI 水平比較差異均無統計學意義（ P均＞0.05）。結論 AMI患者直接進行PCI手術，髮生無複流現象與血漿TF水平呈正相關，TFPI具有阻止血栓形成的作用，也可防治無複流現象。
목적：통과측정급성심기경사（AMI）환자적혈장조직인자（TF）、조직인자도경억제물（ TFPI）수평재직접경피관상동맥성형술（ PCI）전후적변화，연구량자여직접개입후무복류적관계。방법선택급진행PCI적AMI환자53례，용ELISA법검측환자PCI술전、술후즉각、술후24 h외주정맥혈TF、TFPI수평。근거유무복류분위무복류조여재관류조，비교2조불동시점TF、TFPI수평적변화。결과 PCI전、PCI후즉각、PCI후24 h무복류조혈장TF、TFPI수평균명현고우재관류조（ P균＜0．01）；PCI후즉각，2조TF수평균교술전명현승고（P균＜0．01）；PCI후24 h，TF수평무복류조비술전고（P＜0．05），재관류조여술전비교차이무통계학의의（ P＞0．05）； PCI전후2조TFPI 수평비교차이균무통계학의의（ P균＞0.05）。결론 AMI환자직접진행PCI수술，발생무복류현상여혈장TF수평정정상관，TFPI구유조지혈전형성적작용，야가방치무복류현상。
Objective It is explore the relationship of no-reflow with plasma tissue factor ( TF) and tissue factor pathway inhibitor ( TFPI) by determining their changes before and after direct percutaneous coronary angioplasty ( PCI) in patients with acute myocardial infarction ( AMI) .Methods 53 patients with AMI undergoing emergency PCI were selected and the levels of plasma TF and TFPI peripheral venous blood in these patients were determined by ELISA at preoperative, postoperative time points and 24 h after PCI.The patients were divided into no-reflow group and reperfusion group according with or without re-flow, and the changes of TF and TFPI at different time point were compared between the two groups.Results The levels of plasma TF,TFPI at every time point were obviously higher in no-reflow group than that in reperfusion group (P<0.01).The level of TF in both groups were significantly higher after PCI instantly than that before operation (P<0.01), and the level at 24 h after operation in no-reflow group was higher than that before operation (P<0.05), but no significant difference was found in reperfusion group (P>0.05).There was no significant difference in TFPI level between the two groups before and after operation.Conclusion Occurrence of no-reflow is positively correlated with plasma TF level in the patients with AMI un-dergoing emergency PCI, TFPI can prevent and control the occurrence of no reflow because of its inhibiting effect of thrombo-sis.
