急性心肌梗死合并高尿酸血症患者血浆纤溶酶原激活抑制物-1和蛋白Z的变化及意义

The change and significance of plasminogen activator inhibitor-1 and protein Z in acute myocardial infarction patients accompanied by hyperuricemia

目的 研究急性心肌梗死（AMI）患者在合并高尿酸血症（HUA）时血浆纤溶酶原激活抑制物-1（PAI-1）和蛋白Z（PZ）的变化,并探讨其意义.方法 根据血尿酸水平将AMI患者分成尿酸正常组（非HUA-AMI组）61例和高尿酸血症组（HUA-AMI组）50例,健康体检者50例为对照组;检测三组AMI患者TG、TC、LDL-C、HDL-C、PAI-1和PZ指标的变化.结果 与对照组比较,非HUA-AMI组、HUA-AMI组TG、TC、LDL-C及PAI-1明显升高,HDL-C、PZ明显降低（P〈0.001）;与非HUA-AMI组比较,HUA-AMI组TG、TC、LDL-C、PAI-1升高,而HDL-C、PZ降低（P〈0.05或P〈0.001）.结论 AMI合并HUA患者PAI-1活性进一步升高,PZ水平进一步下降,提示HUA可能促进血栓形成,与AMI发生、发展有关.

Objective To investigate the alteration of plasminogen activator inhibitor - 1 （PAI- 1 ） and protein Z （PZ） in acute myocardial infarction （AMI） patients accompanied by hyperuricemia （HUA） and to explore their clinical significance. Methods According to the serum uric acid levels, AMI patients were divided into 2 groups： non - HUA - AMI （61 cases） and HUA - AMI （50 cases） group. Fifty healthy adults were selected as control. The level of serum TG, TC, LDL -C, HDL- C, PAI- 1 and PZ of all patients were determined. Results The levels of serum TG, TC, LDL- C and PAI- 1 were significantly higher, while the HDL- C and PZ were significant lower （P 〈 0. 001 ） in the non - HUA - AMI and HUA - AMI groups compared with those in the control group. The levels of serum TG, TC, LDL - C and PAI- 1 were significant higher, while the HDL - C and PZ were significant lower （P 〈 0.05 or P 〈 0.001 ） in the HUA -AMI group compared with those in the non - HUA- AMI group. Conclusion The progressive alterations of PAl - 1 and PZ in AMI patients accompanied by HUA suggest that HUA may promote the thrombosis, which is associated with the occurrence and development of AMI.