Soria C, Soria J, Mirshahi M, Mirshahi M, Dunnica S, Boucheix C, Beaufils R, Slama R, Caen J P
Thromb Res. 1987 Feb 15;45(4):383-92. doi: 10.1016/0049-3848(87)90227-1.
It has been shown that myocardial infarction (MI) is caused by thrombotic occlusion of a coronary artery. A thrombotic process is also involved in the flow obstruction associated with peripheral embolization in unstable angina (UA). In UA, a local fibrinolytic process should occur, but biological evidence has never been reported. Therefore, we measured sequential changes in plasma fibrin degradation products (FDP) in patients with stable and unstable angina pectoris without MI and compared the levels to those in patients with MI. FDP determination was carried out by ELISA using a D neo monoclonal antibody allowing low amounts of FDP to be reliably and precisely detected. Our results show an early increase in FDP in UA indicating a thrombolytic process. In patients who presented only one episode of chest pain, a prompt decrease of FDP was noted whereas in patients with recurrent chest pain, the levels of FDP remained high. On the contrary, during the first 3 days of uncomplicated MI, FDP levels were not significantly different from those of normal control suggesting an absence of clot dissolution. This study underlines the important function of fibrinolysis in the spontaneous evolution of acute coronary syndrome.
研究表明，心肌梗死（MI）是由冠状动脉血栓性闭塞引起的。血栓形成过程也参与了不稳定型心绞痛（UA）中与外周栓塞相关的血流阻塞。在UA中，局部纤溶过程应该会发生，但尚未有生物学证据报道。因此，我们测量了无MI的稳定型和不稳定型心绞痛患者血浆纤维蛋白降解产物（FDP）的连续变化，并将其水平与MI患者进行比较。FDP的测定采用ELISA法，使用D neo单克隆抗体，可可靠且精确地检测少量FDP。我们的结果显示，UA中FDP早期升高，表明存在溶栓过程。仅出现一次胸痛的患者，FDP迅速下降，而反复胸痛的患者，FDP水平持续升高。相反，在无并发症的MI的前3天，FDP水平与正常对照组无显著差异，表明无血栓溶解。本研究强调了纤溶在急性冠状动脉综合征自然演变中的重要作用。
