动脉粥样硬化性疾病患者血浆纤溶活性的变化及与血脂的关系

Changes of Fibrinolytic Activity in Plasma and the Relationship between theFibrinolytic Activity and the Serum Lipids in Patients with Atherosclerotic Diseases

为观察动脉粥样硬化性疾病患者血浆纤溶活性的变化及其与血脂的关系，本实验分别采用发色底物法、酶联免疫吸附测定法和酶法对３１例动脉硬化性疾病患者血浆纤溶活性和血脂水平进行了测定，并对它们的相关性进行了分析。结果发现动脉粥样硬化患者止浆Ⅰ型纤溶酶原激活剂抑制物活性较对照组开高（１２．５０±５．０６比６．９３±３．８２ｋＡＵ／Ｌ，Ｐ＝０．００３１）；组织型纤溶酶原激活剂含量增加（８．９４±３．５３比５．３６±２．３３μｇ／Ｌ，Ｐ＝０．０００１）。血浆纤溶成分与血脂相关性分析表明：Ⅰ型纤溶酶原激活荆抑制物活性与总胆固醇、甘油三酯、低密度脂蛋白胆固醇呈正相关（ｒ＝０．３２７，Ｐ＝０．０１０１）。结果提示，动脉粥样硬化患者血浆纤溶活性下降是由于Ⅰ型纤溶酶原激活剂抑制物活性增高所致，高血脂可通过使Ⅰ型纤溶酶原激活荆抑制物合成分泌增加而影响血浆纤溶活性。

Aim To observe the changes of fibrinolytic activityin plasma of patients with atherosclerotic diseases and the relation between the fibrinolytic activity and the serum lipids.Methods 31 patients with atherosclerotic diseases were compared with 30 healthy subjects.Results The type 1 plasminogen activator inhibitor (PAI-1) activity and the tissue type plasminogen activator(tPA) antigen in plasma were higher in the atherosclerotic than in the control group (12. 50±5. 06vs 6. 93±3.82 kAU/L,P=0. 0031: and8. 94±3.53vs 5.36±2.33 μg/L,P=0. 0001) , respectively In personal correction analysis , plasma PAI-1 activity correlated positively with serum total cholesterol(TC),triglyceride (TG) and low density lipoprotein cholesterol (LDLC)(r=0. 270～0. 526.P=0. 0001～0.0356).The plasma tPA antigen correlated positively with serum TG(r=0.32.P=0.0101).Conclusions The hypofibrinolysis is due to the plasma PAI-1 level elevating , but not to the tPA less producing.The higher serum concentration of TC and TG could stimulate the PAI-1 synthesis and secretion by the endothelium , which impaires fibrinolyticactivity in plasma.