脑梗塞、冠心病血脂代谢与纤溶酶原激活物抑制物关系的研究

Relationship between cerebral infarction, coronary heart disease and plasminogen activator inhibitors

为探讨脑梗塞及冠心病血脂代谢紊乱与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 ,采取合理有效的干预性治疗方法改善低纤溶状态。测定 112例脑梗塞、81例冠心病患者及 45例健康体检者血总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (LDLC)、高密度脂蛋白胆固醇 (HDLC)、非高密度脂蛋白胆固醇 (nHDLC) ,同时测定纤溶酶原激活物抑制物活性 (PAI -1∶A)并进行比较分析。结果显示 :脑梗塞组及冠心病组患者血浆TG、nHDLC含量增高 ;血浆PAI -1∶A明显升高 ,与正常组比较差异均有高度显著性 (P <0 .0 1)。经多因素回归分析 ,脑梗塞组及冠心病组TG、nHDLC水平与血浆PAI -1∶A呈正相关 (P <0 .0 1)。提示脑梗塞及冠心病患者组血清TG ,nHDLC增高作为PAI -1∶A增高的独立因素 ,而PAI -1活性增高致心脑血管血栓性疾病的机率增加。纠正血脂代谢紊乱可改善纤溶活性 。

In order to investigate the relationship and significance between the blood-lipid metabolism of cerebral infarction and coronary heart disease and the plasma plasminogen inhibitor activator 1 (PAI-1) activity, the rational effective intervention methods were taken to improve the hypofibrinolytic state. The content of blood total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC) and non high density lipoprotein cholesterol (nHDLC) in 112 patients with cerebral infarction, 81 with coronary heart diseases and 45 healthy individuals were measured, meanwhile, the plasminogen activator inhitor 1 activity (PAI-1:A) was also measured and compared. Results showed that the content of plasma TG, nHDLC increased in patients with cerebral infarction and coronary heart disease, the plasma PAI-1:A increased significantly, and there were significant differences in comparing to the control group (P<0.01). After being analyzed by using multiple factor regression, the levels of TG and nHDLC in the cerebral infarction group and the coronary heart disease group had positive correlation with PAI-1:A (P<0.01). This study indicated that the increasing of serum TG, nHDLC in patients with cerebral infarction and coronary heart disease could only cause the increaseing of PAI-1:A, but the increasing of PAI-1 activity may induce the probability of cardio-cerebral vascular throbotic dieases. The correction of disturbance of blood-lipid metabolism could improve the fibrinolytic activity and result in reducing the incidence of cardio-cerebral blood vessel diseases.