The changes of fibrinolytic system and reactive oxygen species production during acute myocardial ischemia

通过测定血浆组织纤溶酶原激活物（t-PA）抗原和纤溶酶原激活物抑制剂（PAI）活性，探讨不稳定型心绞痛合并急性心肌梗死患者纤溶系统的变化。不稳定型心绞痛组血浆PAI活性水平高于稳定型劳累型心绞痛组和对照组。不稳定型心绞痛组血浆t-PA抗原水平高于稳定型劳累型心绞痛组和对照组。稳定型劳役心绞痛组与对照组PAI活性及t-PA抗原水平无显著差异。治疗后，不稳定型心绞痛组PAI活性和t-PA抗原水平均降至稳定型劳役型心绞痛组和对照组水平。因此，不稳定型心绞痛患者血浆PAI活性升高表明这些患者的纤溶系统受损。为了研究急性心肌梗死（AMI）患者的纤溶能力，我们对47例Q波AMI患者进行了血浆PAI活性和t-PA抗原的基线水平测定，这些患者在症状出现后0.2小时进行了急诊冠状动脉造影（3.0 <±>）。如果他们的梗死相关动脉闭塞，他们接受尿激酶冠状动脉内溶栓治疗。根据溶栓治疗前后梗死相关动脉通畅程度分为3组：通畅组（13例）、再通组（23例）、闭塞组（11例）。AMI患者血浆PAI活性的平均水平总体上高于对照组。与对照组相比，通畅组低，再通组和闭塞组高。闭塞组的水平低于再通组，闭塞组中62%的患者水平在对照组范围内。AMI患者血浆t-PA抗原的平均水平总体高于对照组。3个AMI组间差异无统计学意义。因此，本研究表明，在溶栓治疗前后，基线血浆纤溶能力与梗死相关动脉的通畅度之间存在显著关系。我们通过外周血化学发光法检测了AMI患者、稳定的外伤性心绞痛患者和对照组患者的多形核白细胞（PMLS）的活性氧产生。结果表明，AMI患者pml被激活，pml活性氧的产生增加。少

The change of fibrinolytic system in patients with unstable angina and acute myocardial infarction is examined by measuring plasma tissue plasminogen activator (t-PA) antigen and plasminogen activator inhibitor (PAI) activity. The plasma levels of PAI activity were higher in unstable angina group than in stable exertional angina group and control group. The plasma levels of t-PA antigen were also higher in unstable angina group than in stable exertional angina group and control group. There were no significant differences in PAI activity and t-PA antigen levels between stable exertional angina group and control group. Furthermore, both PAI activity and t-PA antigen levels in unstable angina group decreased to the levels in stable exertional angina group and control group after treatment. Thus, the increased plasma PAI activity in patients with unstable angina indicates that the fibrinolytic system is impaired in these patients.To examine the fibrinolytic capacity in patients with acute … More myocardial infarction (AMI), baseline levels of plasma PAI activity and t-PA antigen were measured in 47 patients with Q wave AMI who underwent emergent coronary angiography 3.0 <plus-minus> 0.2 hours after the symptom onset. They had administration of intracoronary thrombolysis with urokinase if their infarct-related arteries were occluded. They were divided into 3 groups according to the patency of the infarct-related artery before and after thrombolytic therapy : the patent group (13 patients), the recanalized group (23 patients), and the occluded group (11 patients). The mean level of plasma PAI activity was higher in the patients with AMI as a whole than in the control group. The level was lower in the patent group and higher in the recanalized group and the occluded group than in the control group. The level was lower in the occluded group than in the recanalized group and 62% of the patients in the occluded group had the levels within the range of the control group. The mean level of plasma t-PA antigen was higher in the patients with AMI as a whole than in the control group. There was no difference in the level among the 3 AMI groups. Thus, this study indicates that there is a significant relation between the baseline plasma fibrinolytic capacity and the patency of the infarct-related artery before and after the thrombolytic therapWe examined reactive oxygen species production of polymorphonuclear leukocytes (PMLS) in patients with AMI, in thosh with stable exertional angina and in control patients by using chemiluminescence assay of peripheral blood. It was showed that PMLs were activated and the production of reactive oxygen species of PMLs was increased in the patients with AMI. Less