Ferlito S, Gallina M, Mangiameli S, Chiaranda G
Institute of I Medical Clinics, University of Catania, Italy.
Panminerva Med. 1995 Sep;37(3):133-6.
The authors carried out a study on the behavior of some thrombotic molecular "markers" in a group of patients suffering from myocardial infarction, just after the first symptoms and after two weeks from the event. The series consists of 12 subjects (6 males, 6 females, mean age 52 +/- 7), suffering from acute myocardial infarction; just after the first symptoms and instrumental signs (before the thrombolysis) and after two weeks a venous blood withdrawal was done; on the plasma of each sample the determination of fibrinogen (F) (coagulative method), tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), D-dimer (D-D), fibrinopeptide A (FPA) and betathromboglobulin (BTG) (ELISA methods) was performed. The values of t-PA, FPA and BTG did not show remarkable variations; after two weeks from the myocardial infarction compared to the basal values a significant reduction of PAI-1 (4.6 +/- 0.28 UI/ml vs 5.4 +/- 0.33 UI/ml, p < 0.01), D-D (215 +/- 10 ng/ml, vs 253 +/- 12 ng/ml, p < 0.05) and a significant increase of F (294 +/- 28, vs 218 +/- 16 mg%, p < 0.05) were observed. The authors suggest that a basal reduction of the fibrinolytic activity documented by the enhanced PAI-1, may play a major role, influencing pathogenetically the thrombotic event; the other markers seem to be of lower importance, being only secondarily altered in the first phase and gradually returning to a normal pattern after an adequate elapsed time; a preinfarctual hypofibrinolytic condition, probably enhanced by some triggering factor, actually appears the sole prothrombotic system to be counteracted with adequate diet and drug treatments.
作者对一组心肌梗死患者在首次出现症状后及发病两周后的一些血栓形成分子“标志物”的行为进行了研究。该系列包括12名患有急性心肌梗死的受试者（6名男性，6名女性，平均年龄52±7岁）；在首次出现症状和体征后（溶栓前）以及两周后采集静脉血；对每个样本的血浆进行纤维蛋白原（F）（凝固法）、组织纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制剂（PAI-1）、D-二聚体（D-D）、纤维蛋白肽A（FPA）和β-血小板球蛋白（BTG）（酶联免疫吸附测定法）的测定。t-PA、FPA和BTG的值未显示出显著变化；与基础值相比，心肌梗死后两周PAI-1显著降低（4.6±0.28 UI/ml对5.4±0.33 UI/ml，p<0.01），D-D显著降低（215±10 ng/ml对253±12 ng/ml，p<0.05），F显著升高（294±28对218±16 mg%，p<0.05）。作者认为，PAI-1升高所记录的纤溶活性基础降低可能起主要作用，在发病机制上影响血栓形成事件；其他标志物似乎重要性较低，仅在第一阶段继发改变，并在适当时间后逐渐恢复正常模式；梗死前纤溶功能减退状态，可能由某些触发因素增强，实际上似乎是唯一需要通过适当饮食和药物治疗来对抗的促血栓形成系统。
