Martínez-Sales V, Vila V, Réganon E, Goberna M A, Ferrando F, Palencia M A, Aznar J
Research Center, Department of Clinic Pathology, La Fe University Hospital, Valencia, Spain.
Haemostasis. 1998 Nov-Dec;28(6):301-6. doi: 10.1159/000022446.
This study examines the evolution of the thrombotic activity in patients with myocardial infarction (MI) treated with aspirin (200 mg/day) for 2 years after MI. Plasma samples of 10 patients were collected at 7, 30, 60, 90, 120, 150, 180, 360 and 720 days. In all the samples we measured fibrinogen (Fg), high molecular weight Fg (HMW-Fg), fibrinopeptide A (FPA), prothrombin fragment 1+2 (F1+2), beta-thromboglobulin (beta-TG), von Willebrand factor (vWF), tissue factor (TF) and TF pathway inhibitor (TFPI). The plasma Fg, HMW-Fg, FPA, F1+2, beta-TG and vWF levels were significantly elevated in the patients at the beginning of the study as compared to the normal group. The 95% confidence intervals were Fg 277-333 mg/dl, HMW-Fg 200-244 mg/dl, FPA 5.3-16.5 ng/ml, F1+2 1.4-1.8 nmol/l, beta-TG 110-118 IU/ml and vWF 139-195%. At thirty days Fg and HMW-Fg returned to normal levels, whereas the increase in FPA and F1+2 levels persisted throughout the study. At 120 and 150 days, respectively, beta-TG and vWF returned to normal levels. The increase in thrombin generation and activity pointed to a persistent hypercoagulable state 2 years after MI. Plasma levels of TF and TFPI showed no statistically significant variations with respect to the normal values over the 2-year period studied. In conclusion, these results suggest a persistent generation and activity of thrombin and cellular activation in these patients after MI.
本研究考察了心肌梗死（MI）患者在心肌梗死后接受阿司匹林（200毫克/天）治疗2年期间血栓形成活性的演变情况。在第7、30、60、90、120、150、180、360和720天采集了10名患者的血浆样本。在所有样本中，我们检测了纤维蛋白原（Fg）、高分子量纤维蛋白原（HMW-Fg）、纤维蛋白肽A（FPA）、凝血酶原片段1+2（F1+2）、β-血小板球蛋白（β-TG）、血管性血友病因子（vWF）、组织因子（TF）和组织因子途径抑制剂（TFPI）。与正常组相比，研究开始时患者血浆中的Fg、HMW-Fg、FPA、F1+2、β-TG和vWF水平显著升高。95%置信区间为：Fg 277 - 333毫克/分升，HMW-Fg 200 - 244毫克/分升，FPA 5.3 - 16.5纳克/毫升，F1+2 1.4 - 1.8纳摩尔/升，β-TG 110 - 118国际单位/毫升，vWF 139 - 195%。在第30天时，Fg和HMW-Fg恢复到正常水平，而FPA和F1+2水平的升高在整个研究过程中持续存在。分别在第120天和150天时，β-TG和vWF恢复到正常水平。凝血酶生成和活性的增加表明心肌梗死后2年存在持续的高凝状态。在研究的2年期间，血浆TF和TFPI水平与正常值相比无统计学显著差异。总之，这些结果表明心肌梗死后这些患者存在凝血酶的持续生成和活性以及细胞激活。
