摘要
观察２４例急性心肌梗塞（ＡＭＩ）患者的血清脂蛋白（ａ）［Ｌｐ（ａ）］动态变化及其与静脉法溶栓疗效关系。结果表明，ＡＭＩ患者的Ｌｐ（ａ）呈一过性升高，７～１４天达峰值，溶栓组比对照组峰值较快降至基线水平。Ｌｐ（ａ）浓度在溶栓不成功、住院期死亡或梗塞范围大的患者中增高更为明显，提示Ｌｐ（ａ）水平变化与ＡＭＩ溶栓疗效及急性期预后间可能有一定的联系。另外，还发现ＡＭＩ发病后早期组织型纤溶酶原激活物（ｔ－ＰＡ）活性及纤溶蛋白原溶解活性下降、纤溶酶原激活物抑制物（ＰＡＩ）活性升高；静脉滴注尿激酶或去纤酶后均可使ｔ－ＰＡ和纤溶活性升高，而且用药后第１～３天还使ＰＡＩ活性及纤维蛋白原含量明显降低，Ｌｐ（ａ）、血脂及纤溶指标相互之间相关性不甚明显。
The dynamic changes of serum LP (a) Levels and the effects of thrombolysis were studied in 24 cases of acute myocardial infarction , including 15 treated by intravenous infusion of urokinase or difibrase and 9 with conventional therapy as control. It showed that LP (a) levels increased transiently, peaked during 7-14th day after onset and decreased toward baseline around 28th day in all cases. Comparing with baseline levels, the LP (a) levels increased by 74. 1 % on the 7th day in thrombolysis group and by 108% on the 14th day in controls, it decreased to baseline in thrombolysis group at 28th day, but not in controls. LP (a)j level was significantly higher in patients with unsuccessful thrombolysis (499. 5± 271. 0 mg/L n= 8 , M±S) than those with successful thrombolysis (259. 4 ± 142. 9 , n = 7), and also higher in dead cases (595. 8±284. 1, n= 6) than in the survivals (322. 8± 200. 0 ,n = 18). There was significant positive correlation between the size of infarct and LP (a) level (r= 0. 74, p<0. 001). It indicates that serum LP (a) level may be related to thrombolytic effectiveness or acute phase prognosis to some extent. In addition, the activities of t-PA and fibrinogenolysis declined, and that of PAI increased during early periods of infarction. After intravenous infusion of thrombolytic agents (urokinase or difibrase), the activities of t-PA and fibrinogenolysis increased, while the PAI activity and fibrinogen level decreased significantly in difibrase group from the lst to 3rd day after onset. Correlations between LP (a), lipids and fibrinolysis parameters, were found.
出处
《中国循环杂志》
CSCD
1994年第1期2-6,共5页
Chinese Circulation Journal
关键词
心肌梗塞
脂蛋白
血栓溶解
Acute myocardial infarction (AMI)
Fibrinolysis
Lipids
Lipoprotein (a)[Lp (a )]
Thrombolysis
