检测血浆uPA、uPAR、t-PA和PAI-1水平在缺血性心脑血管疾病发病中的意义

Clinical analysis of blood plasma levels of uPA,uPAR,t-PA and PAI-1 in patients with ischemic cardio-cerebral-vascular disease

目的研究缺血性心脑血管疾病患者血浆uPA、uPAR、t-PA和PAI-1的水平及意义。方法应用ELISA法测定急性脑梗死、急性心肌梗死及不稳定型心绞痛患者血浆uPA、uPAR、t-PA和PAI-1的水平。结果①脑梗死患者急性期血浆uPA轻度升高(P】0.05),恢复期明显回落(P【0.05),uPAR水平在急性期明显升高(P【0.01),恢复期进一步升高;t-PA含量在急性期明显低于对照组(P【0.01),而PAI-1含量则明显高于对照组(P【0.01),恢复期PAI-1水平趋于正常,而t-PA水平与对照组比较仍存在一定差异(P【0.05)。②急性心肌梗塞患者血浆u-PAR水平急性期明显升高(P【0.05),恢复期进一步升高(P【0.01),uPA水平均大致正常;急性期血浆中t-PA及PAI-1含量均明显高于对照组(P【0.01),恢复期明显回落,PAI-1趋于正常,t-PA水平仍高于对照组(P【0.05)。③不稳定型心绞痛患者急性期(入院时)血浆u-PAR水平明显升高(P【0.01),恢复期(有效治疗二周后)回落,但仍明显高于对照组(P【0.05),u-PA水平与对照组比较均未见明显差异(P】0.05);急性期t-PA含量明显低于正常组(P【0.01),而PAI-1含量略高于对照组(P】0.05),恢复期两者含量均趋于正常(P】0.05)。结论缺血性心脑血管疾病患者存在不同程度的凝血纤溶系统失平衡,对疾病的发生发展起重要作用。

Objective To study the blood plasma levels and significance of uPA,u-PAR,t-PA and PAI-1 in patients with ischemic cardio-cerebral-vascular disease.Methods The blood plasma levels of uPA,uPAR,t-PA and PAI-1 in patients with acute cerebral infarction,acute myocardial infarction and unstable angina pectoris were measured by ELISA.Results Compared with the control group,(1)uPA level increased slightly at acute stage in patients with cerebral infarction(P>0.05),while obviously fell back at restoration stage(P<0.05);uPA level increased significantly at acute stage(P<0.01)and increased more at restoration stage;t-PA level was obviously lower(P<0.01),while PAI-1 significantly higher(P<0.01)at restoration stage;PAI-1 decreased to normal level while t-PA level was different from the control group at restoration stage.(2)u-PAR level increased obviously at acute stage(P<0.05)and increased more at restoration stage(P<0.01)in patients with acute myocardial infarction,uPA levels were nearly normal at both stages;t-PA and PAI-1 levels were obviously higher at acute stage(P<0.01)but decreased obviously at restoration stage till a normal PAI-1 level and a still higher level of t-PA(P<0.05).(3)u-PAR level increased in patients with unstable angina pectoris at acute stage(P<0.01)while fell back at restoration stage after two weeks therapy but still higher than that of the control(P<0.05).No obvious difference was found for uPA level(P>0.05).t-PA level was evidently lower than that of the control(P<0.01)and PAI-1 level was slightly higher than that of the control(P>0.05)at acute stage,while there were no difference after two week’s therapy.Conclusion There were different degrees of unbalance for coagulation and fibrinolytic system in patients with ischemic cardio-cerebral-vascular disease,which was quite important for the generation and development of disease.