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抑制物活性的关系

The Relationship between Concentraion of Plasma Lipoprotein (a) and Activity of Tissue Type Plasminogen Activator and Plasminogen Activator Inhibitor in Patients with Coronary Heart Disease

为了了解冠心病患者血浆脂蛋白（a）浓度与组织型纤维蛋白溶解酶原激活剂及其抑制物活性的关系，进一步研究脂蛋白（a）促血栓形成的机理，本文应用酶联免疫吸附法测定20例冠心病患者与20名健康人脂蛋白（a）浓度，并以底物显色法测定其血浆组织型纤维蛋白溶解酶原激活剂及其抑制物活性。结果发现，冠心病组血脂蛋白（a）浓度和纤维蛋白溶酶原激活剂抑制物活性显著高于对照组，而纤维蛋白溶解酶原激活剂活性显著低于对照组；两组脂蛋白（a）浓度与纤维蛋白溶解酶原激活剂活性无关，而与纤维蛋白溶解酶原激活剂抑制物活性呈显著正相关。提示血浆高脂蛋白（a）浓度是冠心病的危险因素，冠心病患者纤溶与凝血功能失去平衡，促进了冠状动脉内血栓形成与动脉硬化的发展，进而导致和加重冠心病。

Plasma concentration of lipoprotein(a) were measured by enzyme linked immunosorbentassay in 20 patients with coronary heart disease(CHD) and 20 healthy peoples. Plasma activity levelsof tissue type plasminogen activator (tPA) and plas-minogen activator inhibitor (PAI) were determined byspectrophotometric assay. Plasma concentration oflipoprotein (a) and activity of PAI in CHD group weresignificantly higher than the control group, however-plasma activity of tPA in CHD group were significant-ly lower. The plasma concentration of lipoprotein(a) in patients with CHD was not correlated with ac-tivity of tPA, but significantly positive correlated withactivity of PAI. It suggests that elevated plasmaconcentration of lipoprotein (a) is a risk factor forCHD. The results of this study showed also that plas-ma activity of tPA decrease and those of activity PAIof increase in the patients with CHD, which implythat reduced fibrinolytic capacity is related to CHD.High levels of lipoprotein (a) plasma may impair thefibrino1ytic system resueting in thrombose especiallyin the arterial system.