经皮冠状动脉介入治疗（PCI）后血浆活化的凝血因子 XII A 型（XIIaA）浓度的变化。

Changes of plasma activated Factor XII type A (XIIaA) concentrations following percutaneous coronary intervention (PCI).

作者信息

Pönitz Volker, Pritchard David, Grundt Heidi, Mehus Mai-Britt, Nilsen Dennis Winston T

机构信息

Department of Medicine, Stavanger University Hospital, POB 8100, 4068 Stavanger, Norway.

出版信息

J Thromb Thrombolysis. 2007 Oct;24(2):131-5. doi: 10.1007/s11239-007-0041-9. Epub 2007 May 11.

DOI:10.1007/s11239-007-0041-9

PMID:17492403

Abstract

BACKGROUND

Recent research has demonstrated that in-vivo XIIa exists in a number of different types and that treatment with tenecteplase increases the plasma concentration of XIIaA. Only limited data exist on changes in activated Factor XII (XIIa) levels following mechanical revascularisation, such as percutaneous coronary intervention (PCI).

METHODS

Citrated blood samples were obtained from 31 PCI-treated patients admitted with ST-elevation myocardial infarction (STEMI) and 20 patients undergoing elective PCI. Samples were taken immediately before the invasive procedure, 30-90 min after PCI and (in patients undergoing primary PCI) 4-6 days following intervention. Additional samples were taken after angiography, just prior to the follow-on PCI procedure, in 16 of the patients undergoing elective PCI, to investigate possible effects of contrast fluid and heparin. XIIa measurements were performed using 2 ELISA assays designed to preferentially measure different types of XIIa; XIIaA and XIIaR.

RESULTS

In the group undergoing primary PCI, XIIaA showed a significant increase from 68 (48-93) pM in the pre-treatment sample to 100 (75-123) pM [median and 25- and 75% percentiles] in the 30-90-min post-treatment sample (p < 0.001), returning to pre-intervention levels by day 4-6. A similar increase in XIIaA was obtained in patients undergoing elective PCI. In contrast, no significant changes in XIIaR concentration were observed. Whilst XIIaA concentrations remained unchanged in 6 non-heparinised patients undergoing elective coronary angiography, XIIaA levels rose significantly from 56 (51-75) pM to 98 (71-125) pM [median and 25- and 75% percentiles], (p < 0.01) in 10 patients after the addition of heparin.

CONCLUSION

A significant short-lasting increase in specific types of XIIa (namely XIIaA) was observed following PCI. These increases are most likely induced by the concomitant treatment with heparin.

摘要

背景

最近的研究表明，体内的因子XIIa（XIIa）存在多种不同类型，并且使用替奈普酶治疗会增加XIIaA的血浆浓度。关于机械血管重建（如经皮冠状动脉介入治疗（PCI））后活化因子XII（XIIa）水平的变化，仅有有限的数据。

方法

从31例因ST段抬高型心肌梗死（STEMI）接受PCI治疗的患者和20例接受择期PCI的患者中采集枸橼酸化血液样本。样本在侵入性操作前、PCI后30 - 90分钟以及（接受直接PCI的患者）干预后4 - 6天采集。在16例接受择期PCI的患者中，在血管造影后、后续PCI操作前额外采集样本，以研究造影剂和肝素的可能影响。使用两种旨在优先测量不同类型XIIa（XIIaA和XIIaR）的ELISA检测方法进行XIIa测量。

结果

在接受直接PCI的组中，XIIaA在治疗前样本中从68（48 - 93）pM显著增加至治疗后30 - 90分钟样本中的100（75 - 123）pM[中位数及25%和75%百分位数]（p < 0.001），在第4 - 6天恢复到干预前水平。接受择期PCI的患者中也观察到XIIaA有类似增加。相比之下，未观察到XIIaR浓度有显著变化。在6例未接受肝素治疗的接受择期冠状动脉造影的患者中，XIIaA浓度保持不变，而在10例添加肝素后的患者中，XIIaA水平从56（51 - 75）pM显著升至98（71 - 125）pM[中位数及25%和75%百分位数]（p < 0.01）。