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目的：研究急性冠脉综合症患者冠状循环局部血液TF/TFPI 改变。方法：入选40 名冠状动脉造影患者，其中不稳定心绞痛（Unstable pectoris, UP）20 例，稳定性心绞痛(Stable pectoris, SP)和正常对照组各10 例。所有受试者在冠状动脉造影时，同时经导管抽取主动脉根部、冠状静脉窦和股静脉血样,采用ELISA 法测定血浆TF、TFPI 水平，计算TF/TFPI 比值。结果：三组受检者基本情况均相似，UA 组和SA 组冠心病危险因素无统计学差异。股静脉血中TF、TFPI 浓度及TF／TFPI 比值比较：UA 组和SA 组血 TF 水平显著高于对照组，UA 组血TF 水平显著高于SA 组。UA 组血TFPI 水平低于SA 组及对照组;SA 组血TFPI 水平略低于对照组，但未达到统计学意义;UA 组血TF／TFPI 比值显著高于对照组和SA 组,SA 组与对照组比较差异无统计学意义。不同部位血TF、TFPI 水平及TF／TFPI 比值比较：UA 组冠状静脉窦血中TF 水平较主动脉根部显著升高，CS-AO 差值显著高于FV-AO 差值；UA 组冠状静脉窦血TFPI 水平较主动脉根部有升高趋势，但差异无统计学意义，而TF/TFPI 比值较主动脉根部升高，差异有统计学意义，CS-AO 差值显著高于FV-AO 差值。血TF、TFPI 水平及TF/TFPI 比值在股静脉与主动脉根部之间差异无统计学意义 (P>0.05)。SA 组和对照组血TF、TFPI 水平及TF／TFPI 比值三部位间差异无统计学意义。结论：冠脉循环TF／TFPI 比值能较敏感地反映ACS 的情况。

英文摘要:

Objectives: To study the levels of TF/TFPI in coronary circulation of patients with acute coronary syndrome. Methods: 40 cases of hospitalized patients who underwent coronary angiography were enrolled in this study. Patients with unstable angina pectoris （UA）was 20 case, with stable angina pectoris 10 cases and normal 10 cases. Angiogra- phy was performed according to the regular procedure. All the subjects were taken blood from the femoral vein, the root of aortic artery and the coronary sinus during angiography procedure, respectively. Results: The base data were nonsignificantly among the three groups. The occurrence of risk factors of coronary artery disease was similar between the UA and SA patients. TF concentrations of the UA and SA patients were higher than that of the controls, while the UA patients showed a higher concentration than the SA. The UA patients had a lower level of TFPI than the SA and controls.The UAP patients had a greater ratio of TF/TFPI than the controls and SA (P<0.05). There was no difference between the SAP and controls in TF/TFPI. TF concentration in the coronary sinus was increased sig- nificantly compared with that in the root of aortic artery in the UA group. The difference between CS-AO was greater than that between FV-AO (P<0.05). Level of TFPI in the coronary sinus had a trend towards increase compared with that in the root of aortic artery，while TF/TFPI showed significant increase, and the difference between CS-AO was greater than that between FV-AO (P<0.05)；there were no differences of TF，TFPI levels and ratio of TF/TFPI between the femoral vein and the root of aortic artery. No differences of TF, TFPI levels and ratio of TF/TFPI existed among the three locations in patients with SA and the controls(P>0.05). Conclusion: TF/TFPl is a sensitive marker to reflect the ACS.

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