冠心病病人血浆纤溶成分与血脂水平评价

Evaluation of t-PA, PAI, D-dimer and Lipid Levels in Patients with CHD

探讨冠心病（ＣＨＤ）患者血浆组织型纤溶酶原激活剂（ｔ－ＰＡ）、纤溶酶原激活剂抑制剂（ＰＡＩ）、交联纤维蛋白二聚体（Ｄ－ｄｉｍｅｒ）及脂蛋白（ａ）［ Ｌｐ（ａ）］等血浆水平变化、临床应用价值以及其相互间的关系。方法： ｔ－ＰＡ、ＰＡＩ、ＬＰ［ａ］、Ｄ－ｄｉｍｅｒ采用ＥＬＩＳＡ双抗体夹心法检测，胆固醇、甘油三酯采用酶法测定。结果：４７例ＣＨＤ ，患者血浆ｔ－ＰＡ－ＰＡＩ及Ｄ－ｄｉｍｅｒ测值为（９．７±５．７）、（８０．５±３０．０）、（２０９±１２５）ｎｇ ／ｍｌ，其中ｔ－ＰＡ，和Ｄ－ｄｉｍｅｒ值明显高于健康对照组（Ｐ＜０．００１），ＰＡＩ含量两组水平差别不明显（Ｐ＞０．０５）．血浆ＬＰ（ａ）、ＴＧ及ＨＤＬ浓度两组间差别有统计学意义（Ｐ＜０．０５）。用准确性评价各项指标临床应用价值，以Ｄ－ｄｉｍｅｒ为最佳，Ｌｐ（ａ）次之。血浆ｔ－ＰＡ与Ｌｐ（ａ）及ＴＧ含量呈正相关。ＰＡＩ与血浆ＴＧ呈正相关，和ＨＤＬ呈负相关。结论：ｔ－ＰＡ、Ｄ－ｄｉｍｅｒ、ＬＰ（ａ）与粥样斑块及血栓形成有密切关系。

To investigate (l) the levels of plasma t-PA, PAI, D-dimer and lipids in patients with CHD, (2) clinical significance of these indexes, (3) the relationship between t-PA, PAI and D-dimer, Lp(a). Method: t-PA, PAI, D-dimer, LP(a) were determined by enzyme-linked immunosorbent assay; lipids were tested according to the Kit's introduction. Results: 47 patients with CHD, their t-PA, PAI and D-dimer levels were: 9. 7 ± 5. 7, 80. 5 ± 30. l, 209 ± 125 ng/ml respectively, t-PA and D-dimer levels were significantly elevated in patients compared with 40 controls (P< 0. 001 ). The accuracy rate of D- dimer was 85 %, it was the best index for clinical practitioners to chase. The significant correlation was found between t-PA, PAI and TG levels. Conclusion: The compounds related with fibrinolysis such as t-PA and D-dimer, LP(a) were important risk factors for patients with CHD.