冠心病患者血浆脂蛋白（a）浓度与组织型纤溶酶原激活剂及其抑制物活性的关系

Relationship between plasma lipoprotein (a) concentration and activities of t-PA and PAI-1 in patients with coronary heart disease

采用酶免法测定４０例不同伴发病的冠心病患者及２０例健康人的血浆脂蛋白（ａ）［Ｌｐ（ａ）］浓度，并以发色底物法测定其中１６例无伴发病的冠心病患者及１６例健康人的血浆组织型纤溶酶原激活剂（ｔ－ＰＡ）及其抑制物（ＰＡＩ－１）活性。结果显示：冠心病伴发糖尿病组平均ＬＰ（ａ）浓度显著高于正常对照组及冠心病无伴发病组；冠心病患者及健康人血浆Ｌｐ（ａ）浓度与其ｔ－ＰＡ活性无关，而与其ＰＡＩ－１活性呈显著正相关。为此我们认为：伴发糖尿病可能是老年及老年前期冠心病患者血浆Ｌｐ（ａ）浓度升高的原因之一；Ｌｐ（ａ）可能增加ＰＡＩ－１活性，进而促进冠脉内血栓形成。

Abstract In this study, plasma lipoprotein (a) [LP (a)] concentrations of 40 cases of coronary heart disease (CHD)with various complications and 20 controls were measured by enzyme-linked immunosorbent assay (ELISA)Plasma activities of t-PA and PAI-1 were determined by spectrophotometric assay in 16 of the 40 cases of CHD without complication and 16 controls. Mean plasma Lp(a) concentration of CHD with diabetes millitus (DM) group was shown to be significantly higher than that of the control group and of CHD without complication group (P<0. 001 and P<0. 01, respectively).Plasma Lp(a) concentrations of patients with CHD and controls did not correlate with their plasma t-PA activity (r=0. 20, P>0. 20 vs r=0. 15 , P>0. 50) , but positively correlated with PAI-1 activity (r= 0. 80 ,P<0.001 , and r= 0. 67 , P<0. 05 , respectively). The results indicate that complicating DM may be one of the causes for the increase of LP (a) concentration in elder patients with CHD, but complicating hypertension is not related to their plasma LP (a) concentration; and LP (a) may increase the plasma PAI activity which in turn might cause coronary thrombosis and progress of atherosclerosis.