经皮冠状动脉腔内成形术对冠心病患者血浆生物活性物质的影响(摘要)

中国循环杂志 1999年第0期第14卷 摘要　冠心病介入治疗

作者：赵安乐　齐国先　曾定尹

单位：辽宁省，营口市中心医院　心内科(115002)　赵安乐；中国医科大学附属一院　心内科　齐国先　曾定尹

　　目的：探讨经皮冠状动脉腔内成形术(PTCA)对冠心病患者血浆内皮素(ET)，组织型纤溶酶原激活剂(tPA)组织型纤溶酶原激活剂抑制物(PAI)及D-二聚体(D-Dimer)的影响。

　　方法：26例住院的冠心病患者，经冠状动脉照影明确有PTCA的适应征并成功地行PTCA，其中男21例、女5例，平均年龄56.5±10.1岁，不稳定性心绞痛18例，高血压病10例，高血脂12例，糖尿病4例，LVEF(65.3±4.46)%,单支血管病变13例，双支血管病变9例，三支血管病变4例，靶血管病变狭窄70%～90%14例，超过90%12例，有侧支循环形成6例。PTCA采用常规右股动脉穿刺，所有患者均于术前及术后常规应用肝素、阿司匹林、噻氯匹定、硝酸盐类、钙拮抗剂，术中常规应用肝素。于球囊首次扩张前及末次扩张后1 h、3 h、24 h分别采动脉血测定ET。于球囊首次扩张前及末次扩张后1 h、8 h、24 h、48 h、8天分别采血测定tPA、PAI及Dimer。

　　结果：血浆ET水平在PTCA术后1 h、3 h明显升高，与术前比较均有显著性差异(P＜0.05),24 h则恢复至术前水平。PTCA术后各时点血浆tPA、PAI活性及D-Dimer含量均无明显变化(P＞0.05)。

　　结论：PTCA对冠心病患者血浆ET水平有影响，对血浆tPA、PAI活性及D-Dimer含量无影响。

The Effects of Percutaneous Transluminal Coronary Angioplasty on Plasma Bioactive Substance in Patients with Coronary Heart Disease (Abstract)

Department of Cardiology, Central hospital of Yingkou, Yingkou (115002), Liaoning

　　zhao Anle, Qi Guoxian, Zeng Dingyin, et al.

　　objective: To investigate the effects of percutaneous transluminal coronary angioplasty (PTCA) on Endothelin(ET), tPA, PAI, D-Dimer in patients with coronary heart disease.

　　Methods: the changes of plasma ET, tPA, PAI, D-Dimer were observed in 20 patients with coronary heart disease who accepted successful PTCA.

　　Results: the plasma ET level at 1 hour, 3 hours after PTCA was significantly raised(p＜0.01) and recovered 24 hours after PTCA (p＞0.05). No differences in plasma tPA, PAI and D-Dimer were found between before and after PTCA(p＞0.05).

　　Conclusion: pTCA is of an effect on plasma ET level, but with no effects on plasma tPA, PAI and D-Dimer.