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目的 :探讨急性心肌梗死 (AMI)患者全身纤溶状态及内皮纤溶储备功能的变化规律。方法 :2 1例 AMI患者于入院第 1天和入院后第 10天采集静脉血测定纤溶指标 ,并与 15例正常人作对比 ,同时做静脉闭塞试验以确定最大内皮组织纤溶酶原激活剂 (t PA)释放。结果 :AMI患者 t PA含量、纤溶酶原激活剂抑制物 - 1(PAI- 1)活性均较正常人明显为高。最大内皮 t PA释放于入院第 1天降低为 (2 .3± 0 .9) μg/ L(P<0 .0 1) ,第 10天恢复至(4.5± 1.2 ) μg/ L(P >0 .0 5 )。结论 :内皮纤溶功能紊乱与血管内血栓形成的联系要比全身纤溶指标的变化更为密切 ,在 AMI早期纠正内皮纤溶功能异常更为重要
Objective: To investigate the changes of systemic fibrinolytic system and endothelial fibrinolytic reserve in patients with acute myocardial infarction (AMI). Methods: A total of 21 patients with AMI were enrolled on the first day of hospitalization and the 10th day after hospital admission to collect the fibrinolytic index. The fibrinolytic index was compared with that of 15 normal subjects and the venous occlusion test was performed at the same time to determine the maximal endothelial tissue plasminogen activator Agent (t PA) release. Results: The levels of t PA and plasminogen activator inhibitor - 1 (PAI - 1) in AMI patients were significantly higher than those in normal controls. The maximum endothelial t PA release decreased to (2.3 ± 0.9) μg / L (P <0.01) on day 1 and returned to (4.5 ± 1.2) μg / L on day 10 (P> 0 .0 5). Conclusions: The relationship between endothelial fibrinolysis disorder and intravascular thrombosis is more closely related to systemic fibrinolysis, and it is more important to correct the abnormal fibrinolytic function in early stage of AMI