Hara M, Ito K, Nawata T, Tsunematsu Y, Shimoyama N, Maeda T, Sato Y, Saikawa T, Sakata T
Department of Internal Medicine, Health Insurance Nankai Hospital, Oita, Japan.
Cardiology. 1995;86(5):407-10. doi: 10.1159/000176911.
To determine which reperfusion therapy for acute myocardial infarction (AMI) is advantageous to avoid subsequent thrombotic coronary occlusion, 8 patients with AMI were studied. Four of them (group S) underwent sequential PTCA following unsuccessful intracoronary thrombolysis and the others (group D) direct PTCA. Serial changes in plasma plasminogen activator inhibitor-1 (PAI-1), plasma tissue plasminogen activator (t-PA) antigen and serum lipoprotein(a) levels were compared between the two groups. In group S, plasma PAI-1 levels showed no significant serial change after PTCA. However, in group D, plasma PAI-1 levels increased significantly 4-24 h after PTCA. We suggest that more attention should be focused on the prevention of thrombotic coronary closure as well as mechanical abrupt occlusion after direct PTCA.
为确定哪种急性心肌梗死（AMI）再灌注治疗有利于避免随后的冠状动脉血栓闭塞，对8例AMI患者进行了研究。其中4例（S组）在冠状动脉内溶栓失败后接受序贯PTCA，其余患者（D组）接受直接PTCA。比较了两组血浆纤溶酶原激活物抑制剂-1（PAI-1）、血浆组织纤溶酶原激活物（t-PA）抗原和血清脂蛋白（a）水平的系列变化。在S组，PTCA后血浆PAI-1水平无明显系列变化。然而，在D组，PTCA后4-24小时血浆PAI-1水平显著升高。我们建议，应更加关注直接PTCA后冠状动脉血栓闭塞以及机械性突然闭塞的预防。
