两类心绞痛患者胰岛素抵抗和纤溶酶原激活抑制物-1的比较

Comparison of insulin resistance and plasminogen activator inhibitor 1 in two types of angina pectoris patients

目的 两种不同类型心绞痛胰岛素抵抗和纤溶功能的比较 .方法 狭窄性心绞痛 (AP)组 2 7例 ;微血管性心绞痛(MV)组 17例 ;对照组 13例 .分别测量患者身高 ,体质量和血压 .冠状动脉造影前 ,空腹 12 h抽取静脉血 ,测定血脂 ,空腹血糖 ,胰岛素 (Ins) ,C-肽 (C- P)和纤溶酶原激活抑制物 - 1(PAI- 1) .结果 AP和 MV组血清 Ins分别为 (2 3± 8)m IU· L- 1 和 (2 5± 6 ) m IU· L- 1 ,均明显高于对照组 (15± 5 )m IU· L- 1 (P<0 .0 5 ) ;C- P分别为 (2 .7± 0 .9) μg· L- 1和 (3.1± 0 .8)μg· L - 1 均明显高于对照组 (2 .0± 0 .9)μg· L- 1 (P<0 .0 5 ) ,AP和 MV组胰岛素敏感性指数 (Ins I)均明显低于对照组 0 .0 1± 0 .0 1vs 0 .0 2± 0 .0 1(P<0 .0 5 ) ,以上各指标在AP和 MV组间没有差异 (P>0 .0 5 ) .AP组血浆 PAI- 1为(3.2± 0 .9) AU· m L- 1 ,明显高于 MV组 (2 .5± 0 .6 ) AU·m L- 1和对照组 (2 .5± 0 .4) AU·m L- 1 (P<0 .0 5 ) ,MV组和对照组间没有差异 (P>0 .0 5 ) . AP患者血浆 PAI- 1分别与血清Ins(r=0 .484,P<0 .0 5 )和 C- P(r=0 .5 2 1,P<0 .0 5 )正相关 .AP和 MV组 TG,TC明显高于对照组 (P<0 .0 5 ) ,此两组间没有差异 (P>0 .0 5 ) .结论 AP和 MV患者都存在胰岛素抵抗 ,?

AIM To compare insulin resistance(InsR) and plasminogen function in two types of angina pectoris patients and to investigate their clinical significance. METHODS Filly serven angina pectoris patients given coronary arteriography were divided into 3 groups:27 angina pectoris cases of defined stenosis coronary artery (Group,AP), 17 microvascular angina cases (Group,MV), and 13 cases (Control). The height, mass and blood pressure of each patient were measured. Before the arteriography, venous blood was obtained after a 12 hour fasting to determine lipidemia, fasting plasma glucose, insulin(Ins), C peptide(C P) and plasminogen activator inhibitor 1(PAI 1). RESULTS Serum Ins in AP and MV groups were (23±8) and (25±6)mIU·L -1 , which were much higher than that in the control (15±5)mIU·L -1 ( P <0.05);C P of AP and MV groups were (2.7±0.9) and (3.1±0.8)μg·L -1 and significantly higher than that of the control (2.0±0.9)pmol·L -1 ( P <0.05). InsI in The AP and MP groups were lower than that in the control group (0 01±0.01 vs 0.02±0.01( P <0.05). There was no significant difference between group AP and MV in respect of the above indexes. Plasma PAI 1 in AP group was (3.2±0.9)×10 3 AU·L -1 , and significantly higher than that in group MV (2.5±0.6) and that in the control group (2.5±0.4) ( P <0 05). There was no difference between MV group and the control group in respect of their AU·mL -1 ( P <0.05). The plasma PAI 1 in AP patients was correlated with both serum Ins ( r =0.484, P <0.05) and C P ( r =0.521, P <0.05).TG and TC in AP and MV groups were higher than that in the control group ( P <0.05). There was no significant difference between in the TG and TC in AP and MV groups. CONCLUSION There exists InsR in the AP and MV patients to a similar extent. There is a disorder in the plasminogen function in AP patients. The degree of the disorder correlates with the degree of InsR. The different levels of PAI 1 may contribute to the formation of the different types of angina pectoris.