【作者】 张铭朋；

【导师】 刘向群；

【作者基本信息】 山东大学 ， 老年医学， 2006， 硕士

【摘要】 背景：不稳定性心绞痛(unstable angina，UA)严重危害老年人身体健康，局部冠状动脉粥样硬化斑块由稳定转为不稳定，继而破裂导致血栓形成是UA的主要发病机理。明确不稳定性斑块发生的分子机制以及识别不稳定性斑块，进而采取有效的干预措施，已成为冠心病研究领域的热点。 近年来，凝血纤溶系统的变化与冠心病发生、发展的关系越来越受到人们的重视。凝血酶激活的纤溶抑制物(thrombin-activatable fibrinolysis Inhibitor，TAFI)作为凝血纤溶活性的调节因子，在心脑血管血栓性疾病发生、发展中起重要作用。研究发现心绞痛的发生、UA的顽固性与血浆TAFI水平相关。因此，TAFI在UA发生、发展中可能发挥一定作用，并且TAFI水平的调节可能对UA病情的控制具有重要意义。 由于不稳定性心绞痛患者存在凝血纤溶活性的失调，因此抗凝治疗在其防治措施中占有重要地位。低分子量肝素(low-molecular-weight heparin，LMWH)和普通肝素(standard unfractionated heparin，UFH)能有效降低UA患者心肌梗死等严重心脏事件。LMWH较UFH有许多优点，作为UFH的替代品逐渐为临床所接受。既往研究表明，LMWH通过增强抗凝血酶活性、促进组织因子通道抑制剂释放、降低血管假性血友病因子浓度、促进纤溶功能等途径发挥抗凝作用。TAFI作为连接凝血和纤溶两大系统的活性调节分子，可能是LWMH治疗UA过程中抗凝作用途径之一。更多还原

【Abstract】 Background: Unstable angina (UA) is a common and multi-onset disease, which has serious effects on the health of the aged. The major pathogenesis of UA is the instability of local coronary atherosclerotic plaque and arterial thrombogenesis secondary to the plaque disruption. It has become a hot spot of precaution and therapy in coronary heart disease (CHD) that identifying and recognizing molecular mechanism of the plaque instability, then taking effective measures on prevention and cure.The more and more close attentions are paid to association between the development of CHD and active variance in the system of thrombosis and fibrinolysis. Recently, thrombin-activatable fibrinolysis Inhibitor (TAFI) has attached more importance as a factor regulatory to activity of thrombosis and fibrinolysis in cardiovascular and cerebrovascular diseases. Clinical studies have indicated plasma TAFI levels were related to development of angina pectoris and refractory UA Therefore, TAFI is likely to play a partial role in the development of UA, and the regulation of TAFI levels is potential significant to improve UA patients’ clinical更多还原