Kamikura Y, Wada H, Yamada A, Shimura M, Hiyoyama K, Shiku H, Tanigawa M, Nishikawa H, Yamada N, Isaka N, Nakano T, Kumeda K, Kato H
Second Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Mie-ken, Japan.
Am J Hematol. 1997 Aug;55(4):183-7. doi: 10.1002/(sici)1096-8652(199707)55:4<183::aid-ajh3>3.0.co;2-o.
We examined hemostatic abnormalities in 23 patients with acute myocardial infarction (AMI), 10 with pulmonary embolism (PE), and 10 with deep vein thrombosis (DVT). At the onset of AMI, plasma levels of tissue-type plasminogen activator (t-PA), PA inhibitor-I (PAI-I), fibrin-D-dimer, thrombin-antithrombin complex (TAT), and plasmin-plasmin inhibitor complex (PPIC) were significantly increased. Both the plasma total TFPI and free-TFPI levels in the AMI patients were significantly higher than those in the healthy volunteers, PE patients, and DVT patients. There was no significant difference in total TFPI or free-TFPI among patients with PE, those with DVT, and healthy volunteers. One hour after percutaneous transluminal coronary angioplasty (PTCA) in the AMI group, the total TFPI level was further increased, and it was significantly reduced 24 hr after PTCA, to a level similar to that in healthy volunteers. Free-TFPI showed a pattern similar to that of total TFPI. The ratio of free-TFPI/total TFPI was highest 1 hr after PTCA. Increased TFPI in AMI patients might be released from ischemic tissues.
我们检测了23例急性心肌梗死（AMI）患者、10例肺栓塞（PE）患者和10例深静脉血栓形成（DVT）患者的止血异常情况。在AMI发病时，组织型纤溶酶原激活物（t-PA）、PA抑制剂-I（PAI-I）、纤维蛋白D-二聚体、凝血酶-抗凝血酶复合物（TAT）和纤溶酶-纤溶酶抑制剂复合物（PPIC）的血浆水平显著升高。AMI患者的血浆总组织因子途径抑制物（TFPI）和游离TFPI水平均显著高于健康志愿者、PE患者和DVT患者。PE患者、DVT患者和健康志愿者之间的总TFPI或游离TFPI无显著差异。AMI组经皮腔内冠状动脉成形术（PTCA）后1小时，总TFPI水平进一步升高，PTCA后24小时显著降低，降至与健康志愿者相似的水平。游离TFPI呈现出与总TFPI相似的模式。PTCA后1小时，游离TFPI/总TFPI的比值最高。AMI患者TFPI升高可能是从缺血组织中释放出来的。
