Shammas N W, Cunningham M J, Pomerantz R M, Francis C W
Cardiology Unit, University of Rochester School of Medicine and Dentistry, New York 14642.
Thromb Haemost. 1994 Nov;72(5):672-5.
To characterize the extent of early activation of the hemostatic system following angioplasty, we obtained blood samples from the involved coronary artery of 11 stable angina patients during the procedure and measured sensitive markers of thrombin formation (fibrinopeptide A, prothrombin fragment 1.2, and soluble fibrin) and of platelet activation (beta-thromboglobulin). Levels of hemostatic markers in venous blood obtained from 14 young individuals with low pretest probability for coronary artery disease were not significantly different from levels in venous blood or intracoronary samples obtained prior to angioplasty. Also, there was no translesional (proximal and distal to the lesion) gradient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first balloon inflation. Furthermore, no significant difference was noted between angioplasty and postangioplasty intracoronary concentrations. We conclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angioplasty when high doses of heparin and aspirin are administered.
为了描述血管成形术后止血系统早期激活的程度，我们在手术过程中从11例稳定型心绞痛患者的受累冠状动脉采集了血样，并测量了凝血酶形成的敏感标志物（纤维蛋白肽A、凝血酶原片段1.2和可溶性纤维蛋白）以及血小板激活的敏感标志物（β-血小板球蛋白）。从14名冠状动脉疾病预测试概率较低的年轻个体采集的静脉血中的止血标志物水平，与血管成形术前采集的静脉血或冠状动脉内样本中的水平无显著差异。此外，在首次球囊扩张开始后18至21分钟采集的样本中，血管成形术前或术后，任何止血标志物在病变处（病变近端和远端）均无梯度变化。此外，血管成形术期间和术后冠状动脉内浓度之间无显著差异。我们得出结论，当给予高剂量肝素和阿司匹林时，大多数患者在冠状动脉血管成形术期间及术后即刻不会发生冠状动脉内止血激活。
