血浆纤溶酶原激活物抑制物1、胰岛素抵抗与冠状动脉病变程度的关系

Interrelation between plasminogen activator inhibitor1,insulin resistance and the extent of coronary artery disease

目的:研究血浆纤溶酶原激活物抑制物1(PAI1)、胰岛素抵抗和冠心病患者冠状动脉病变程度的关系。方法:对120例患者行冠脉造影,其中冠心病组60例,非冠心病组60例,测定血清胰岛素、血浆PAI1抗原含量等指标,各检测指标与冠状动脉病变严重度积分(CSS)行直线相关分析及多因素逐步回归分析。结果:随着冠状动脉病变支数的增加,PAI1水平逐渐增高,INS敏感性指数逐渐下降。血浆PAI1水平、空腹胰岛素和胰岛素抵抗与冠状动脉病变范围和病变程度密切相关。多元逐步回归发现血浆PAI1抗原含量与冠脉病变严重性积分和支数相关。结论:血浆PAI1水平和胰岛素抵抗对预测冠状动脉病变有一定的价值。

Objective:To ascertain whether the plasma level of plasminogen activator inhibitor l(PAI 1)antigen and insulin resistance are related to the extent of coronary disease.Methods:The plasma PAI 1antigen was measuned by the enzymlinked immunosorbent assay and fasting insulin by immunoradio-metric assay in120cases who had undergone diagnostic coronary angiography.These cases included60patients with angiographic abnormality diagnosed as CAD and60with normal angiogram.CAD patients were graded on the number of vessels with a luminal diameter reduction≥50%and scoring system for de-termining the severity of CAD.Re sults:CAD patients with abnormal angiogram had higher plasma PAI 1antigen and lower insulin sensitivity.Multivessel CAD had higher plasma PAI 1antigen,insulin,blood glycose,TC and lower insulin sensitivity.Plasma PAI 1antigen,insulin,insulin resistance showed a highly significant correlation with the number of vessels and severity scores of coronary lesions.Stepwise multiple regression analysis showed that plasma PAI 1antigen determined the number of vessels and severity scores of coronary lesions.The study also found that the correlation between PAI 1and insulin was highly signif-icant.Con clu sion:The raise of plasma PAI 1antigen and insulin resistance possesses certain predictive value for the diagnosis of CAD.