非酒精性脂肪肝痰瘀证与纤溶状态的关系

目的 探讨非酒精性脂肪肝(non-alcoholic fatty liver，NAFL)痰瘀证与纤溶状态的关系。方法 将符合NAFL诊断的患者辨证分为痰瘀证组18例与非痰瘀证组52例，并设健康人对照组28名，比较各组纤溶酶原(plasminogen，PLG)、组织纤溶酶原激活物(tissue plasminogen activator，t-PA)、1型纤溶酶原激活物抑制物(plasminogen activator inhibitor-1，PAI-1)、D-二聚体的变化。结果 NAFL患者t-PA活性明显低于健康人对照组(P<0．01)，PLG、PAI-1活性明显高于健康人对照组(P<0．05)；与非痰瘀证组比较，痰瘀证组患者t-PA活性明显降低，PLG、PAI-1活性明显升高(P<0．01)，而D-二聚体差异无显著性(P>0．05)、结论 NAFL痰瘀证患者纤溶活性明显降低，存在不同程度的微循环障碍或高黏状态，采用化痰散瘀治疗有积极意义。

Relationship between Phlegm-Stasis Syndrome and Fibrinolytic Status in Patients with Non alcoholic Fatty Liver

OBJECTIVE: To explore the relationship between phlegm-stasis syndrome (PSS) and the fibrinolytic status in patients with non-alcoholic fatty liver (NAFL). METHODS: Seventy patients with NAFL were divided into the PSS group and non-PSS group according to TCM Syndrome typing, and a control group consisted of 28 healthy subjects was set up. Levels of plasminogen (PLG), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and D-dimer were determined and compared. RESULTS: The activity of t-PA in NAFL patients was significantly lower than that in the control group (P<0.05), and PLG and PAI-1 were significantly higher than those in the control group (P<0.05). In respect to the TCM Syndrome typing, in patients of PSS, t-PA was significantly lower and PLG, PAI-1 were significantly higher than those in patients of non-PSS (P<0.05 or P<0.01), while D-dimer was insignificantly different between patients of the two Syndrome types (P>0.05). CONCLUSION: NAFL patients of PSS type shows significant lower of fibrinolytic activity, indicating that there is certain degree of microcirculatory disturbance and hyper viscosity state, so the application of dissolving phlegm and dispelling stasis principle in treating NAFL is significant.