Vonica A, Văgăonescu T, Cristea A, Stăncioiu N
First Medical Clinic, Cluj-Napoca, Romania.
Med Interne. 1990 Oct-Dec;28(4):311-7.
Plasma antithrombin III was measured by an immunological approach (AT III:Ag) using an antiserum developed in our laboratory and by its ability to inhibit thrombin (functional assay) using a chromogenic synthetic substrate in 12 patients with myocardial infarction, 9 patients with angina pectoris and 10 healthy control subjects. In the early stage (3 to 24 hours after the onset of pain) of an acute myocardial infarction AT III:Ag (115.67% +/- 21.23) was found to be significantly (p less than 0.01) higher than functional (free) AT III (92% +/- 10.27). This difference was less obvious 10 days later (AT III:Ag 118% +/- 18.93; functional AT III 104.94 +/- 14.45). There was also no significant difference between AT III:Ag and functional AT III in patients with angina pectoris as well as in controls. Since AT III:Ag represents total plasma AT III while functional AT III represents only free AT III the difference between these two variables could provide informations about the amount of the anticoagulant forming complexes with activated clotting factors. It is therefore considered that the significant increase in the difference between AT III:Ag and functional AT III in the early stage of acute myocardial infarction is likely to suggest an intravascular activation of coagulation.
采用在我们实验室研制的抗血清，通过免疫方法（抗凝血酶III抗原，AT III:Ag）测定12例心肌梗死患者、9例心绞痛患者和10名健康对照者的血浆抗凝血酶III，并使用发色合成底物通过其抑制凝血酶的能力（功能测定）进行测定。在急性心肌梗死的早期阶段（疼痛发作后3至24小时），发现抗凝血酶III抗原（115.67%±21.23）显著高于功能性（游离）抗凝血酶III（92%±10.27）（p<0.01）。10天后这种差异不太明显（抗凝血酶III抗原118%±18.93；功能性抗凝血酶III 104.94±14.45）。心绞痛患者和对照组的抗凝血酶III抗原与功能性抗凝血酶III之间也没有显著差异。由于抗凝血酶III抗原代表血浆总抗凝血酶III，而功能性抗凝血酶III仅代表游离抗凝血酶III，这两个变量之间的差异可以提供与活化凝血因子形成复合物的抗凝剂数量的信息。因此，认为急性心肌梗死早期抗凝血酶III抗原与功能性抗凝血酶III之间差异的显著增加可能提示血管内凝血激活。
