代谢综合征与血栓前状态．

Metabolic syndrome and prothrombotic state

代谢综合征可通过胰岛素抵抗或中心性肥胖形成血栓前状态。胰岛素抵抗或中心性肥胖可导致纤溶酶原激活物抑制剂-1（PAI-1）、纤维蛋白原、组织因子和凝血因子Ⅶ升高，一氧化氮（N0）生物活性减弱、血管内皮损伤，抑制血小板聚集的能力减弱，使血小板活化。因此，胰岛素抵抗或中心性肥胖通过影响凝血系统、纤溶系统、血小板和血管内皮等促进代谢综合征血栓前状态的形成。

Metabolic syndrome is prone to form prothrombotic state through insulin resistance or central obesity. Insulin resistance or central obesity can increase the levels of plasminogen activator inhibitor-1 （PAI-1） ,fibrinogen,tissue factor and coagulation factor Ⅶ. Insulin resistance can reduce the activity of nitric oxide （NO）, which protects vascular endothehum. Insulin resistance combined with central obesity can lower the function of insulin,which suppresses platelet aggregation. In conclusion,insulin resistance or central obesity can promote the development of prothrombotic state by increasing the level of coagulation factor,inhibiting the fibrinolytic pathway, accelerating platelet activation and damaging vascular endothelial function.