Pacchiarini L, Storti C, Zucchella M, Salerno J A, Grignani G, Fratino P
Department of Internal Medicine, University of Pavia, Italy.
Haemostasis. 1989;19(3):147-51. doi: 10.1159/000215908.
Fibrinopeptide A (FPA) levels were determined in 40 consecutive patients admitted to the coronary care unit with a typical history of chest pain: in 24 of them a diagnosis of acute myocardial infarction (AMI) and in 16 a diagnosis of angina was made. Seven of the patients with AMI suffered from recurrent episodes of early post-infarctional angina. FPA levels were determined in each patient on admission and every 4 h for 48 h. On admission in patients with both angina and AMI the FPA levels were significantly higher than in normal controls; these levels were higher in patients with AMI than in those with angina, but this difference was not significant. In patients with angina the values decreased progressively after 12 h to baseline values, while in those with AMI the high levels of FPA persisted throughout the 48-hour observation period. In many instances, particularly after 24 h, the differences between the two groups were statistically significant. In patients with early post-infarctional angina the episode of angor was preceded by or corresponded to a new great elevation of FPA levels. These data suggest that the thrombin generation is higher and more prolonged in patients with AMI than in those with angina; the determination of FPA levels, which are an index of 'in vivo' thrombin generation, can be useful to follow the clinical course of ischaemic heart disease.
对40例因典型胸痛病史而入住冠心病监护病房的连续患者测定了纤维蛋白肽A（FPA）水平：其中24例诊断为急性心肌梗死（AMI），16例诊断为心绞痛。7例AMI患者出现梗死后早期心绞痛复发。在每位患者入院时以及48小时内每4小时测定一次FPA水平。心绞痛和AMI患者入院时的FPA水平显著高于正常对照组；AMI患者的这些水平高于心绞痛患者，但这种差异不显著。心绞痛患者的FPA值在12小时后逐渐下降至基线值，而AMI患者的FPA高水平在整个48小时观察期内持续存在。在许多情况下，尤其是24小时后，两组之间的差异具有统计学意义。在梗死后早期心绞痛患者中，心绞痛发作之前或发作时FPA水平会再次大幅升高。这些数据表明，AMI患者的凝血酶生成比心绞痛患者更高且更持久；FPA水平的测定作为“体内”凝血酶生成的指标，有助于跟踪缺血性心脏病的临床病程。
