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目的：观察在风湿性心脏病伴心房颤动患者中卡托普利对血浆纤溶活性的作用。方法：将患者随机分组，即试验组３９例在常规治疗基础上加用卡托普利，对照组２１例按常规治疗；治疗前后分别留取血浆测定以下指标：组织型纤溶酶原激活物（ｔ－ＰＡ）活性、纤溶酶原激活物抑制物－１（ＰＡＩ－１）活性、纤溶酶原（Ｐｌｇ）活性、Ｄ－二聚体（Ｄ－ｄｉｍｅｒ）含量。结果：试验组组织型纤溶酶原激活物活性在卡托普利治疗７～１０天后显著性升高（Ｐ＜０．０５），纤溶酶原激活物抑制物－１活性显著性降低（Ｐ＜０．０１）；对照组在常规治疗后所有被检测的纤溶指标均无显著性改变。结论：卡托普利可能主要通过降低血浆纤溶酶原激活物抑制物－１活性而影响纤溶活性，提示卡托普利对防治此类患者动脉栓塞性并发症有益。
Objective: To observe the effect of captopril on plasma fibrinolytic activity in patients with rheumatic heart disease and atrial fibrillation. Methods: The patients were randomly divided into three groups: experimental group (n = 39) received captopril on the basis of routine treatment and control group (n = 21) underwent conventional treatment. The plasma and plasma levels of the following indexes were measured before and after treatment: tissue-type plasminogen activator (T-PA) activity, plasminogen activator inhibitor-1 (PAI-1) activity, plasminogen activator activity and D-dimer content were measured. Results: The activity of tissue plasminogen activator in experimental group was significantly increased after 7-10 days of treatment with captopril (P <0.05), and the activity of plasminogen activator inhibitor-1 was significantly decreased P <0.01). There was no significant change in all fibrinolytic indexes tested in the control group after routine treatment. CONCLUSION: Captopril may affect fibrinolytic activity mainly through decreasing plasma plasminogen activator inhibitor-1 activity, suggesting that captopril may be beneficial in preventing and treating arterial embolism complications in these patients.