老年冠心病患者血浆纤溶活性与胰岛素抵抗的关系

The relationship between activities of coagulative and fibrinolytic system and insulin resistance in aged coronary heart disease patients

目的 探讨纤溶功能变化对老年冠心病患者的临床意义 ,及其与胰岛素抵抗 (IR)的关系。方法 2 0 0 0年 3月～ 2 0 0 1年 5月在我院老年科就诊的老年患者 (≥ 6 0岁 )中 ,随机选择冠心病患者 6 7例 (冠心病组 )和非冠心病患者 77例 (对照组 ) ,检测其血浆组织型纤溶酶原激活剂 (t PA)及其抑制物血浆纤溶酶原激活物抑制剂 1(PAI 1)的抗原及活性、胰岛素和血糖等。结果 冠心病组PAI 1抗原、活性及血清胰岛素水平高于对照组 ,而胰岛素敏感指数 (ISI)降低。冠心病组PAI 1的活性与腰臀比 (WHR)及血清胰岛素水平呈正相关 (r值分别 =0 .5 11和 0 .5 0 3,P <0 .0 5 ) ,而与ISI呈负相关 (r =- 0 .4 73,P <0 .0 5 )。结论 老年冠心病患者的血浆纤溶活性异常 ,并存在IR ,纤溶活性失调与IR有关。

Objective To study the changes of coagulative and fibrinolytic activities in aged coronary heart disease(CHD) patients and to explore the relationship between these changes and insulin resistance.Methods PAI-1, t-PA activities and antigens, plasma insulin, glucose were measured in 67 CHD patients and 77 controls.Results Compared with the controls, ISI was lower; PAI-1 antigen with activity and plasma insulin were higher in CHD group. PAI-1, t-PA/PAI-1 were positively correlated with insulin and WHR but negatively with ISI.Conclusions Abnormal activities of coagulative and fibrinolytic system were found in CHD patients and were correlated with insulin resistance.