胰岛素抵抗与凝血、纤溶功能异常的关系

胰岛素抵抗(IR)是缺血性心脑血管疾病的独立危险因素。凝血、纤溶异常是IR的重要病理组成部分，对于心血管疾病的发生、发展有着重要的意义。在IR状态下，脂肪组织合成的纤溶酶原激活物抑制因子-1(PAI-1)增多，同时因血管内皮细胞功能受损，一氧化氮(NO)生成减少。使机体处于高凝血、低纤溶状态，促使动脉粥样硬化的发生。当B细胞功能失代偿而血糖升高后，机体糖基化终末产物(AGE)生成增加，血管内皮细胞的损伤加重，凝血、纤溶异常进一步发展，加速动脉粥样硬化的形成。因此，深入研究IR状态下的凝血、纤溶异常及针对性治疗具有重要的临床意义。

The relationship of insulin resistance and the abnormal state of thrombosis and fibrinolysis

Insulin resistance(IR) is a independent risk factor of ichemic angiopathy .The abnormal state of thrombosis and fibrinolysis is a critical pathology component of IR,and play a vital role in initiating and developing cardiovasculer disease. Under IR state, the,inhancement of plasminogen-activator inhibitior-1(PAI-1)synthesis by adipose tissue and the reduced generation of nitric oxide with endothelial dysfunction contribute to the hypo-fibrinolytic/pro-thrombotic state and promote atherosclerotic. Accompanied with IR developing, when B cell function can't keep normal glycemia, the advanced glycosylation end products(AGEs) are increased as a result of hyperglycemia. AGEs can aggravate endothelial injury and accelerate the course of atherosclerotic. Fully comprehending the pathogenesis of thrombosis and fibrinolysis in IR and taking therapy for the pathology have clinical significance.