冠心病胰岛素抵抗与纤溶活性的关系

的：探讨冠心病胰岛素抵抗与纤溶活性的相互关系。方法：前瞻性研究，测定60例冠心病病人（30例不稳定型心绞痛和30例急性心肌梗死）和30例正常人的组织纤维蛋白溶酶原激活剂（t—PA）和血浆纤溶酶原激活物抑制剂（PAI）活性；以及空腹胰岛素（Fins），空腹血糖（FBG）。对测量结果进行相关分析。结果：与对照组相比，冠心痛病人FBG无明显变化，Fins、胰岛素敏感指数（ISI）、PAI活性明显较对照组增高，t—PA活性校对照组明显下降。时60例冠心病病人ISI与纤溶活性备指标进行线性相关分析，结果表明：不稳定型心绞痛组FBG、Fins、ISI、胰岛素释放指数与PAI活性呈正相关，与t-PA活性呈负相关；急性心肌梗死组FBG、Fins、ISI与PAI活性呈正相关，与t—PA活性呈负相关。结论：冠心病病人的纤溶活性异常与胰岛素抵抗有关。

RELATIONSHIP BETWEEN INSULIN RESISTANCE AND FIBRINOLYTIC ACTIVITY IN PATIENTS WITH CORONARY ATHEROSCLEROTIC HEART DISEASE

Objective:To study the interrelationship between insulin resistance(IR) and fibrinolytic activity in patients with coronary atherosclerotic heart disease(CHD).Methods:A prospective study was done to measure the tissue plasminogen activator(t-PA),serum plasminogen activator inhibitor(PAI),and fasting insulin(Fins),fasting blood glucose(FBG) in 60 patients with CHD(30 cases with unstable angina pectoris,and 30 cases with acute myocardial infarction) and 30 normal people in control group.Then correlation analysis among the measurements was made.Results:The level of FBG was not significant different between the patients with CHD and normal people.But the level of Fins,insulin sensitivity index(ISI),and PAI were significantly higher in patients with CHD than that of control group.And the level of t-PA was significantly lower in patients with CHD.Linear correlation analysis showed that in 30 cases with unstable angina pectoris,there were positive correlation between FBG,Fins,ISI,insulin release index and PAI,but were negatively correlated with t-PA.In 30 cases with acute myocardial infarction,there were positive correlation between FBG,Fins,ISI and PAI.And there were negative correlation between FBG,Fins,ISI and t-PA.Conclusion:Insulin resistance can make the disorder of fibrinolytic activity and lipid metabolism,and promote the progress of CHD.