高胰岛素血症、纤溶酶原激活物抑制物-1与冠心病关系的初步研究

The Correlation between Coronary Heart Disease and Hyperinsulinemia the Plasma Plasminogen Activator Inhibitor 1

目的 :探讨冠心病与高胰岛素血症、血浆纤溶酶原激活物抑制物 1( PAI- 1)活性变化的关系及意义。 方法 :73例冠心病病人分为急性心肌梗塞组 ( 2 2例 ) ,不稳定性心绞痛组 ( 2 3例 ) ,这组患者治疗后即为不稳定性心绞痛治疗后组 ,稳定性心绞痛组 ( 2 8例 ) ,另设 2 7例正常对照组 ,分别测定血清胰岛素、血浆 PAI- 1、C肽等指标。 结果 :1冠心病病人血浆 PAI- 1和胰岛素、C肽水平明显升高 ,急性心肌梗塞组和不稳定性心绞痛组升高尤其明显( P<0 .0 1) ;2经多因素回归分析 ,冠心病病人血清胰岛素水平与收缩压、血浆 PAI- 1呈正相关 ( P<0 .0 5 )。 结论 :冠心病病人存在胰岛素抵抗。高胰岛素血症可能通过 PAI- 1活性增高致血栓形成机率增加 ,因而引起急性冠状动脉事件。

Objective:To study the correlation between coronary heart disease and hyperinsulinemia and the plasma plasminogen activator inhibitor 1(PAI 1) Methods:Plasma PAI 1 activity,serum insulin and C peptide were measured with enzyme immnoassay and radio immunoassay technique in 27 normal subjects and 73 patients with coronary heart disease(CHD). Results:①Plasma PAI 1 activity,serum insulin and C peptide increased in CHD patients,especially those with acute myocardial(MAI)and unstable angina poctoris (UAP)( p <0 01) ②There were positive correlation between serum insulin and the plasma PAI 1 and systolic blood pressure (SBP)( p <0.05)by multiple regression analysis in patients with CHD. Conclusions:The research showed that the hyperinsulinemiais involved in development of the CHD.When the hyperinsulinemia occurs,the impaired fibrinolytic activity caused by increased plasma PAI 1 activity may accelerate the process of atherosclerosis and induce the acute ischemic events.