急性冠脉综合征患者同型半胱氨酸与纤溶系统的关系

目的研究急性冠脉综合征患者血浆同型半胱氨酸水平与纤溶系统的关系。方法经冠状动脉造影检查确诊为冠心病的患者180例,包括急性冠脉综合征135例,稳定性心绞痛45例,另设正常对照组30例。用高效液相色谱荧光检测血浆总同型半胱氨酸水平,同时测定组织型纤溶酶原激活物和纤溶酶原激活物抑制剂-1,分析各组患者上述指标的关系。结果稳定性心绞痛、急性冠脉综合征两组患者的血浆同型半胱氨酸、组织型纤溶酶原激活物、纤溶酶原激活物抑制剂-1及纤溶酶原激活物抑制剂-1/组织型纤溶酶原激活物水平均明显高于正常对照组(P<0.05)。急性冠脉综合征组同型半胱氨酸、纤溶酶原激活物抑制剂-1及纤溶酶原激活物抑制剂-1/组织型纤溶酶原激活物明显高于稳定性心绞痛组(P<0.05)。在稳定性心绞痛和急性冠脉综合征组血浆同型半胱氨酸水平与纤溶酶原激活物抑制剂-1呈正相关(r=0.439,P<0.01),而与组织型纤溶酶原激活物呈负相关(r=-0.398,P<0.01)。结论稳定性心绞痛和急性冠脉综合征组患者同型半胱氨酸水平升高,且高同型半胱氨酸浓度可以引起纤溶、凝血功能紊乱,对急性冠脉综合征的发病起一定作用。

The Relationship of Homocysteine Levels to Tissue Plasminogen Activator and Plasminogen Activator Inhibitor in Acute Coronary Syndrome Patients

Objective To invesigate the relationship of plasma homocysteine levels to fibrinolytic system in acute coronary syndrome patients.Methods A total 180 patients were diagnosed coronary artery disease by coronary artery angiography for evaluation.135 cases of acute coronary syndrome(ACS) patients,45cases of stable angina pectoris(SAP) patients and 30 normal subjects were enrolled to the study.Plasma total homocysteine(tHcy) levels were measured using high performance liquid chromatography with fluorescence detection,meanwhile,tissue plasminogen activator(t-PA) and plasminogen activator inhibitor(PAI-1) were measured.Analysing the connection among those parameters of patients in every group.Results Plasma tHcy,t-PA,PAI-1 and PAI-1/t-PA levels in SAP patients and ACS patients were higher than that in normal subjects(P<0.05).While plasma tHcy PAI-1 and PAI-1/t-PA levels in ACS patients were higher than that in SAP patients((P<0.05)),and t-PA levels in ACS patients were lower than that in SAP patients.Plasma tHcy levels were found significant association with PAI-1 and t-PA(r-value=0.439 and r-value=(-0.398),P<0.001).Conclusion There was hyperhomocysteinemia in SAP and acute coronary syndrome patients.Hyperhomocysteinemia play an important role in fibrinolytic system in patients with acute coronary syndrome.