高甘油三酯血症与血凝纤溶系统的关系

The Association of Hypertriglyceridemia with Plasma Haemostatic and Fibrinolytic Activities

为研究脂质代谢紊乱与血浆凝血纤溶活性的关系，分别测定了61例高脂血症患者（混合性高脂血症16例和单纯性高甘油三酯血症45例）的血清脂质和血浆反映凝血纤溶活性的有关指标，并与18例正常人对比。结果发现，高脂血症患者的血浆纤溶酶原激活剂抑制物-1、凝血因子VII和凝血因子X活性明显高于正常对照组（P＜0．05～0．001），组织型纤溶酶原激活物活性明显低于正常对照组（P＜0．05）。血清甘油三酯水平与血浆纤溶酶原激活物抑制剂-1、因子VII和因子X活性是显著的正相关性（P＜0．05～0．001），与组织型纤溶酶原激活物活性是显著的负相关性（P＜0．01）；血清胆固醇水平与血浆纤维蛋白原水平和纤溶酶原激活物抑制剂-1活性呈显著的正相关性（P＜0．05）。结果提示，脂质代谢紊乱，特别是高甘油三酯血症可增加体内凝血活性，降低纤溶活性，有利于血栓形成，对动脉粥样硬化的发生和发展有不利的影响。

Aim To ivestigate the association of lipid metabolism disturbance with haemostatic activity and fibrinolytic activity.Methods Serum lipids,some plasma haemostatic and fibrinolytic parameters were determined in 61 pa-tients with hyperlipidemia(hypertriglyceridemia in 45and mixed hyperlipidemia in 16)and compaerd with those in 18 healthy controls.Results The plasma activities of type-1 plasmino-gen activitor inhibitor(PAI-1),coagulation factor VII (F VII)and X(F X)were significantly higher,tissue type plasminogen activitor(tPA)was significantly lower in hyperlipidemic patients when compared with those in healthy controls(P<0.05~0.001). Fur-thermore serum triglyceride level was positively corre-lated with plasma activities of PAI-1,F VII and F X(P <0.05~0.001),and negatively correlated with tPA activity(P<0.01).Serum cholesterol level was also positively correlated with plasma fibrinogen level and PAI-1 activity(P<0.05).Conclusion Hyperlipidemia,especially hyper-triglyceridemia may increase coagulation activity and decrease fibrinolytic activity,benefiting the formation of thrombosis.Therefore,hyperlipidemia is an im portant risk factor for atherosclerosis.