Losito R, Gattiker H, Bilodeau G, Verville N, Longpré B
J Lab Clin Med. 1981 Feb;97(2):241-50.
Since measurements of AT III and other possible coagulation inhibitors might provide an index of hypercoagulability, the goal was to measure over a 3-month period individual changes in blood levels of AT III, alpha 2-microglobulin, and alpha 1-antitrypsin in 51 patients with acute ischemic heart disease who were admitted to a Coronary Care Unit with the following diagnosis: unstable angina (26 patients), acute transmural myocardial infarction (20 patients), or subendocardial myocardial infarction (5 patients). Some patients received prophylactic antithrombotic therapy. AT III was measured by the von Kaulla, Owen, Thrombo-Screen, chromogenic, immunodiffusion, and immunoelectrophoretic methods. Alpha 2-macroglobulin and alpha 1-antitrypsin were measured by immunodiffusion. All inhibitors were measured on three different occasions: (1) on admission to hospital, (1) day of departure from hospital, and (3) at 3 months after hospitalization. Alpha 1-antitrypsin showed a significant increase compared to the control and remained elevated during the 3-month interval. Compared to normal control values, AT III was found to be significantly diminished when measured by one functional method (von Kaulla) in all three blood samples from patients with unstable angina and transmural myocardial infarction and by one immunological method (immunodiffusion) in patients with unstable angina, transmural myocardial infarction, and subendocardial myocardial infarction. Most methods determining functional AT III detected a significant increase 3 months after the acute ischemic episode; this rise was observed more often in patients with myocardial infarction than in those with unstable angina. Stepwise discriminant analysis separated the patients of the three groups. Subcutaneous heparin has no significant effect on AT III levels. Unexplained discrepancies still exist between the results obtained by various functional and immunological methods for determining AT III. It appears, however, that methods measuring functional AT III seem to be more suited than immunological methods to detect changes in AT III levels that might occur during and after an acute episode of ischemic heart disease.
由于对抗凝血酶III（AT III）和其他可能的凝血抑制剂进行测量可能会提供高凝状态的指标，研究目的是在3个月的时间内，对51例入住冠心病监护病房、诊断为以下疾病的急性缺血性心脏病患者的AT III、α2-微球蛋白和α1-抗胰蛋白酶的血液水平的个体变化进行测量：不稳定型心绞痛（26例）、急性透壁性心肌梗死（20例）或心内膜下心肌梗死（5例）。部分患者接受了预防性抗血栓治疗。AT III通过冯·考拉（von Kaulla）法、欧文（Owen）法、血栓筛查（Thrombo-Screen）法、发色底物法、免疫扩散法和免疫电泳法进行测量。α2-巨球蛋白和α1-抗胰蛋白酶通过免疫扩散法进行测量。所有抑制剂均在三个不同时间点进行测量：（1）入院时，（2）出院日，以及（3）住院后3个月。与对照组相比，α1-抗胰蛋白酶显著升高，并在3个月的间隔期内持续升高。与正常对照值相比，在不稳定型心绞痛和透壁性心肌梗死患者的所有三份血样中，通过一种功能方法（冯·考拉法）测量时发现AT III显著降低；在不稳定型心绞痛、透壁性心肌梗死和心内膜下心肌梗死患者中，通过一种免疫方法（免疫扩散法）测量时AT III也显著降低。大多数测定功能性AT III的方法在急性缺血发作3个月后检测到显著升高；这种升高在心肌梗死患者中比在不稳定型心绞痛患者中更常见。逐步判别分析将三组患者区分开来。皮下注射肝素对AT III水平无显著影响。在通过各种功能和免疫方法测定AT III所获得的结果之间，仍存在无法解释的差异。然而，似乎测量功能性AT III的方法比免疫方法更适合检测在急性缺血性心脏病发作期间及之后可能发生的AT III水平变化。
