糖耐量减低患者纤溶受抑的临床观察

目的探讨糖耐量减低(IGT)及IGT合并急性冠状动脉综合征(ACS)患者纤溶受抑状态。方法97例患者随机分成3组,IGT组33例,IGT+ACS组32例,ACS组32例;正常对照组20例。检测血浆中组织型纤溶酶原激活剂(t-PA),纤溶酶原激活物抑制剂-1(PAI-1)及D-二聚体的水平,并计算出PAI-1/D-二聚体的比值。结果IGT组、IGT+ACS组和ACS组血浆t-PA、PAI-1和D-二聚体浓度均显著高于正常对照组(P<0.05,P<0.01);IGT组和IGT+ACS组血浆D-二聚体水平增高幅度则显著低于ACS组(P<0.05,P<0.01);IGT组和IGT+ACS组的PAI-1/D-二聚体比值分别比正常对照组及ACS组明显增高(P<0.01)。结论IGT患者存在纤溶受抑状态,血浆D-二聚体的水平结合PAI-1/D-二聚体比值能反映患者纤溶受抑的状态及预后。

Clinical observation of the status of fibrinolytic inhibition in the patients with impaired glucose tolerance

Objective To investigate the status of fibrinolytic inhibition in the patients of impaired glucose tolerance (IGT) and IGT with acute coronary syndrome (ACS). Methods 97 patients were randomly divided into three groups: IGT group with 33 patients, IGT+ACS group with 32 patients, ACS group with 32 patients and control group with 20 healthy persons. The levels of plasmic tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1) and D-dimer were detected by enzyme linked immunosorbent assay (ELISA) technique and the ratio of PAI-1/D-dimer was calculated. Results The levels of plasmic t-PA, PAI-1 and D-dimer were significantly higher in IGT group, IGT+ACS group and ACS group than those in control group (P0.05,P<0.01), but the increased range of the level of plasmic D-dimer was significantly lower in IGT group and IGT+ACS group than that in ACS group (P<0.05,P<0.01). The ratio of PAI-1/D-dimer was significantly higher in IGT group and IGT+ACS group than that in ACS group and control group (P<0.01) . Conclusions The status of fibrinolytic inhibition is existed in the patients with IGT. The level of plasmic D-dimer and the ratio of PAI-1/D-dimer could be used to reflect the prognosis and status of fibrinolytic inhibition.