论文部分内容阅读
目的:观察不同治疗方法对急性心肌梗死(AMI)患者血浆中凝血因子Ⅶ抗原水平(FⅦag)、活化的凝血因子Ⅶ(FⅦa)、凝血因子Ⅶ活性(FⅦ:C)的影响,并探讨其意义。方法:将80例AMI患者依治疗方法不同分为介入治疗组(40例)和药物(低分子肝素)治疗组(40例),在2组患者入院时、治疗后6,24h及1周采集外周静脉血,以ELISA法测定FⅦag水平,重组可溶性组织因子法测定FⅦa水平,凝血一期法测定FⅦ:C,分析其动态变化,并以20名健康人作为对照组。结果:AMI患者血浆FⅦag、FⅦa水平及FⅦ:C治疗前均高于正常对照组(P<0.05或P<0.01)。2组患者血浆FⅦag水平在治疗后各时间点较治疗前均未见明显波动。介入治疗组血浆FⅦa水平、FⅦ:C在术后6h略有升高,之后又逐渐下降。药物组FⅦa水平、FⅦ:C在治疗后逐渐下降,且其变化幅度大于介入组。进行组内比较时,FⅦa的变化幅度较FⅦ:C更明显。结论:AMI时,患者血浆因子Ⅶ的3种存在形式均明显增加,其中以FⅦa的敏感性最高。低分子肝素抗凝治疗较单纯急诊介入治疗更能明显抑制FⅦ活化,降低患者血浆高凝状态。
OBJECTIVE: To observe the effect of different treatment methods on the levels of plasma coagulation factor Ⅶ antigen, FⅦa and FⅦ: C in patients with acute myocardial infarction (AMI) and to explore its significance . Methods: Eighty patients with AMI were divided into interventional therapy group (40 cases) and drug (low molecular weight heparin treatment group) (40 cases) according to different treatment methods. Two groups of patients were admitted to hospital at 6, 24 hours and 1 week after treatment FⅦag levels were measured by ELISA, FⅦa levels by recombinant soluble tissue factor method, FⅦ: C by coagulation and one-phase assay, and the dynamic changes were analyzed. Twenty healthy subjects were used as control group. Results: The levels of plasma FⅦag and FⅦa and the levels of FⅦ: C in patients with AMI were significantly higher than those in normal controls (P <0.05 or P <0.01). The level of plasma FⅦag in the two groups showed no significant changes at all time points after treatment. Interventional treatment group plasma FⅦa levels, FⅦ: C slightly increased 6h after surgery, and then gradually decreased. FⅦa level of drug group, FⅦ: C decreased gradually after treatment, and the amplitude of change was greater than that of intervention group. When compared within groups, the change in FⅦa was more pronounced than that in FⅦ: C. Conclusions: The three forms of plasma factor Ⅶ in patients with AMI were significantly increased at AMI, of which FⅦa was the most sensitive. Low molecular weight heparin anticoagulant therapy more than simple emergency intervention can significantly inhibit the activation of F Ⅶ, reducing plasma hypercoagulability in patients.