纤溶酶相关蛋白在冠心病患者中的表达

Expression of plasminogen associated protein in the patients suffered from coronary heart disease

目的:了解冠心病患者是否存在组织型纤溶酶原激活物(t-PA)及纤溶酶原激活抑制物Ⅰ(PAI-Ⅰ)功能紊乱,以及这两个指标与血脂、胰岛素抵抗的相关关系。方法:选择2004年1月至2006年1月于我院住院就诊的冠心病患者作为观察对象。按临床类型分为SAP组、UAP组、AMI组、OMI组,并设健康对照组。检测t-PA、PAI-Ⅰ、胰岛素敏感性指数(IAI)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)等指标。结果:(1)健康对照组t-PA高于各型冠心病组(P<0.05),AMI组t-PA低于其余各型冠心病组(P<0.05);健康对照组PAI-Ⅰ低于各型冠心病组(P<0.05),AMI组PAI-Ⅰ高于其余各型冠心病(P<0.05)。(2)t-PA与IAI呈正相关,与TC、TG、LDL呈负相关;PAI-Ⅰ则与IAI呈负相关,与TC、TG、LDL呈正相关。(3)各病例组t-PA于治疗后有所升高,PAI-Ⅰ于治疗后有所下降(P<0.05)。结论:冠心病患者存在明显的纤溶功能紊乱,且以急性期为重,并且纤溶功能紊乱与胰岛素抵抗、血脂异常等因素有关。

Objective To know whether there exists disorder of tissue-type plasminogen activator （t-PA）and Plasminogen Activator Inhibitor （PAI- Ⅰ ） in CHD patients and explore the relationship between these two parameters and blood fat and insulin resistance. Methods The CHD patients who were treated in our hospital during January 2004 to January 2006 were selected as the study objects. All of them were divided into 4 groups according to clinical manifestation ： group SAP, group UAP, group AMI and group OMI. The healthy people were selected as control group. The parameters of t-PA,PAI-Ⅰ ,IAI,TC,TG,LDL of all objects were tested. Results （1）As far as t-PA was concerned, the level in control group was higher than that in all case groups, and that of the AMI group was less than the other case group. However, the condition of PAI- Ⅰ was reverse. （2）There existed positive correlations between t-PA and IAI, TC, TG and LDL, while there existed negative correlations between PAI- Ⅰ and those above. （3）After treatment, t-PA of each case group increased, while PAI- Ⅰ decreased. Conclusion There existed disorder of t-PA and PAI- Ⅰ in CHD patients. This condition was more serious in acute patients. Blood fat and insulin resistance may play important roles in plasminogen disorder.