重组葡激酶静脉溶栓治疗对急性心肌梗塞患者血小板活化的作用

doi:吉林省科技厅自然科学基金资助课题（200105

重组葡激酶静脉溶栓治疗对急性心肌梗塞患者血小板活化的作用

鲁硕^△, 李淑梅^*，崔燕

吉林大学第二医院心内科，吉林长春130041

收稿日期:2005-09-05 修回日期:1900-01-01 出版日期:2006-07-28 发布日期:2006-07-28
通讯作者: 李淑梅

Effects of intravenous thrombolysis with recombinantstaphylokinase on platelet activation parameters in patients with acute myocardial infarction

LU Shuo^△，LI Shu-mei^*，CUI Yan

Department of Cardiology, Second Hospital, Jilin University,　Changchun 130041,China

Received:2005-09-05 Revised:1900-01-01 Online:2006-07-28 Published:2006-07-28
Contact: LI Shu-mei

摘要/Abstract

摘要： 目的：通过与重组组织型纤溶酶原激活剂（rt-PA）对比，观察重组葡激酶（r-SAK）对急性心肌梗塞（AMI）患者溶栓治疗前后血浆中血小板α-颗粒膜蛋白（GMP-140）、凝血酶-抗凝血酶复合物（TAT）含量的影响，评价其对AMI对凝血系统的影响和对血小板活化的作用。方法：选择确诊为AMI发病12 h以内患者33例，随机分为r-SAK治疗组（n=17）和rt-PA对照组（n=16），测定两组溶栓治疗前、溶栓后2 h血浆中GMP-140、TAT含量及溶栓90 min后冠脉造影等相关指标。结果：两组溶栓治疗后血浆中GMP-140含量均高于治疗前（P<0.05）；与r-SAK组溶栓治疗后比较，rt-PA组溶栓治疗后血浆中GMP-140含量显著升高（P<0.05），r-SAK组溶栓治疗后2 h血浆中TAT浓度略有升高（P>0.05），rt-PA组溶栓治疗后2 h 血浆中TAT浓度显著升高（P<0.05）。两组溶栓治疗后再灌注率无明显差异。结论：AMI患者应用r-SAK与rt-PA溶栓治疗有同等的溶栓疗效，r-SAK较rt-PA有更强的血栓选择性，促凝活性微弱，促血小板活化低，减轻血栓前状态对心肌损伤作用，可以改善心肌微灌注。

关键词: 药物疗法, 重组葡激酶, 凝血酶-抗凝血酶复合物, 血小板α-颗粒膜蛋白, 血栓溶解疗法

Abstract: Objective To observe the effects of recombinant staphylokinase (r-SAK) on platelet activation parameters in patients with acute myocardial infarction (AMI) by intravenous thrombolysis in order to investigate the clinical thrombolytic efficacy of r-SAK therapy in AMI comparing with recombinant tissue-type plasminogen activator (rt-PA) therapy. Methods Thirty-three patients with AMI within 12 h after the onset were selected and divided randomly into the r-SAK therapy group (n=17) and rt-PA therapy group (n=16). Coronary artery angiography (CAG) was performed 90 min after thrombolytic therapy in patients. Thrombin-antithrombin complex (TAT) and alpha granule membrane protein (GMP-140) were measured by similar commercial enzyme-linked immunosorbent assay (ELISA). Results In r-SAK group and rt-PA group, the plasma contents of GMP-140 2 h after thrombolytic therapy were significantly higher than before therapy (P<0.05). There was statistically significant difference of the plasma contents of GMP-140 2 h after thrombolytic therapy between two groups (P <0.05). In r-SAK group, the plasma content of TAT 2 h after thrombolytic therapy increased slightly (P>0.05). In rt-PA group, the plasma content of TAT 2 h after thrombolytic therapy increased significantly (P<0.05). There was no statistically significant difference of the reperfusion rate at 2 h after thrombolytic therapy between two groups (P>0.05). Conclusion r-SAK has similar effect with rt-PA and it will become available for highly fibrin-selective thrombolytic therapy of AMI. Thrombolytic treatment with r-SAK can improve the injury of myocardial microperfusion.

Key words: drug therapy, recombinant staphylokinase, thrombin-antithrombin complex, alpha granule membrane protein, thrombolytic therapy

中图分类号:

R542.2

鲁硕, 李淑梅，崔燕. 重组葡激酶静脉溶栓治疗对急性心肌梗塞患者血小板活化的作用[J]. J4, 2006, 32(4): 690-693.

LU Shuo，LI Shu-mei，CUI Yan. Effects of intravenous thrombolysis with recombinantstaphylokinase on platelet activation parameters in patients with acute myocardial infarction[J]. J4, 2006, 32(4): 690-693.

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