氯沙坦和依那普利对心肌梗死后纤溶-凝血功能的影响The effect of losartan and enalapril on haemostatic function in patients with acute myocardial infarction
田洪森,丁文惠,王晓阳,彭旭,唐朝枢
摘要(Abstract)：
目的 探讨氯沙坦和依那普利对急性心肌梗死 (AMI)患者纤溶 凝血功能的影响。方法 将 41例AMI患者随机分为氯沙坦组、依那普利组和对照组 ,以发色底物法和ELISA法测定三组患者入院即刻、发病 2周、2个月的血浆PAI 1活性、纤溶酶原激活物 (tPA)抗原水平和血管血友病病因子(vWF)含量。结果 与对照组相比 ,氯沙坦组 2周和 2个月时的PAI 1活性分别减低 2 2 % (P <0 0 1)和 18% (P <0 0 5 ) ,tPA抗原水平分别减低 32 % (P <0 0 1)和 2 5 % (P <0 0 5 ) ;依那普利组相应分别减低 2 8% (P <0 0 1)和 2 1% (P <0 0 5 ) ,tPA抗原水平分别减低 38% (P <0 0 1)和 2 9% (P <0 0 5 ) ;两个治疗组之间差异无显著性。两种药物对vWF含量均无影响。结论 氯沙坦和依那普利可改善心肌梗死后的纤溶功能 ,长期应用这两种药物可能会降低心肌梗死后发生急性心脏事件的危险。
关键词(KeyWords)： 氯沙坦;依那普利;心肌梗塞;纤溶酶原激活物抑制剂1;血管血友病因子
基金项目(Foundation):
作者(Author): 田洪森,丁文惠,王晓阳,彭旭,唐朝枢
参考文献(References)：
- 1KoenigW .Haemostaticriskfactorsforcardiovasculardisease .EurHeartJ,1998,19(SupplC) :C39 43.
- 2RumleyA ,LoweGD ,SweetnamPM .FactorⅧ ,VonWillebrandfactorandandtheriskofmajorischaemicheartdiseaseinthecaerphillyHeartStudy .BrJHaematol,1999,10 5 :110 116 .
- 3JassonJH ,NilssonTK ,JohnsonO .VonWillebrandfactor,tissueplasminogenactivator,anddehydroepiandrosteronesulphatepredictcardiovasculardeathina 10yearsfellowupofsurvivorsofacutemyocardialinfarction .Heart,1998,80 :334 337.
- 4Torp pedersenC ,KoberL ,CarlsenJ,onbehalfoftheTRACEStudyGroup.Angiotensin convertingenzymeinhibitionaftermyocardialinfarction :theTrandoprilCardiacEvaluationStudy .AmHeartJ ,1996 ,132 (1,part2 ) :2 35 2 45 .
- 5VaughanDE ,RowleauJL ,RidkerPM ,etal.Effectoframiprilonplasmafibrinolyticbalanceinpatientswithacuteanteriormyocardialinfarction .Circulation ,1997,96 :442 447.
- 6MoriyamaY ,OgawaH ,OshimaS ,etal.Captoprilreducedplasminogenactivatorinhibitoractivityinpatientswithacutemyocardialinfarction .JpnCircJ,1997,6 1:30 8 314 .
- 7NishmuraH ,TsujiH ,MasudaH ,etal.AngiotensinIIincreaseplasminogenactivatorinhibitor 1andtissuefactormRNAexpressionwithoutchangingthatoftissuetypeplasminogenactivaorortissuefactorpathwayinhibitioninculturedrataorticendothelialcells.ThrombHaemost,1997,77:1189 1195 .
- 8WilminkHW ,BangaJD ,HijmeringM ,etal.Effectofangiotensin convertingenzymeinhibitionandangiotensinIItype 1receptorantagonismonpostprandialendothelialfunction .JAmCollCardiol,1999,34:14 0 14 5 .