冠心病合并高胰岛素血症患者血浆PAI-1与冠脉病变的相关性

目的:探讨冠心病合并高胰岛素血症患者血浆纤溶酶原激活物抑制物1(plasminogen activator inhibitor-1, PAI-1)水平与冠状动脉病变程度的关系及意义. 方法:收集97例冠心病患者,其中单纯冠心病组32例,冠心病合并糖耐量异常(IGT)组31例,冠心病合并2型糖尿病(T2DM)组34例. 所有患者均采用放射免疫法测定血清空腹胰岛素(INS),发色底物法测定血浆PAI-1活性. 根据住院期间冠脉造影(CAG)结果,采用冠脉狭窄程度积分(coronary narrow degree integral)统计冠脉狭窄程度,作为冠脉病变程度的指标. 结果:冠心病合并2型糖尿病组的血浆PAI-1、胰岛素水平及冠脉狭窄程度积分均较单纯冠心病组及冠心病合并糖耐量异常组明显升高;冠心病合并糖耐量异常组明显高于单纯冠心病组(P<0.05);相关分析显示,在冠心病合并高胰岛素血症患者中,血浆PAI-1水平与血清INS水平及冠脉狭窄程度积分呈正相关. 结论:冠心病合并高胰岛素血症患者存在纤溶活性异常,同时血浆PAI-1水平与血清INS水平及冠脉狭窄程度相关.

Relationship between the level of PAI-1 and extent of coronary lesions in CHD patients accompanied with hyperinsulinmia

AIM: To explore the relationship between the level of plasminogen activator inhibitor-1 (PAI-1) and the extent of coronary lesions in coronary heart disease (CHD) patients accompanied with hyperinsulinmia. METHODS: Ninety-seven CHD patients were included in the study: simple CHD group (32), CHD accompanied with impaired glucose tolerance (IGT) group (31) and CHD accompanied with type 2 diabetes mellitus (T2DM) group (34). The levels of serum insulin and plasma PAI-1 of all the patients were analyzed by radio immunoassay and chromogenic assay, respectively. All the patients also had coronary angiography and the extent of coronary lesions was analyzed by total amount integral method. RESULTS: The levels of serum insulin, plasma PAI-1 and coronary artery narrow degree in CHD accompanied with T2DM group were significantly higher than those of simple CHD group and CHD accompanied with IGT group, and those of CHD accompanied with IGT group were significantly higher than those of simple CHD group(P<0.05). Correlation analysis showed that the levels of PAI-1 and insulin were positively correlated with the coronary artery narrow degree in CHD patients accompanied with hyperinsulinmia. CONCLUSION: Abnormal activity of fibrinoytic system occurs in CHD patients accompanied with hyperinsulinmia. The levels of PAI-1 and insulin are positively correlated with coronary artery narrow degree in CHD patients accompanied with hyperinsulinmia.