高血糖合并冠心病患者血管性假性血友病因子、纤溶酶原激活剂抑制物及脂联素水平研究

目的探讨高血糖合并冠心病患者血管性假性血友病因子（vWF）、纤溶酶原激活剂抑制物1（PAI-1）及脂联素水平及其意义。方法163例明确诊断冠心病患者，行口服75g葡萄糖耐量试验确诊冠心病合并2型糖尿病44例（26．99％），冠心病合并单纯糖耐量低减59例（24．38％），冠心病合并单纯空腹血糖受损15例（7．46％），冠心病正常糖代谢40例（24．54％）。应用酶联免疫吸附法检测糖尿病组、糖耐量低减组、空腹血糖受损组及正常糖耐量组的vWF、PAI-1及脂联素水平。结果糖尿病合并冠心病组、糖耐量低减合并冠心病组vWF均明显高于正常血糖组，具有显著统计学意义。糖尿病合并冠心病组PAI-1较正常血糖组明显增高，具有统计学意义，而糖耐量低减组及空腹血糖受损组与正常血糖组无明显差异。糖尿病及糖耐量低减组脂联素较正常血糖组明显降低，具有统计学意义，空腹血糖受损组和正常血糖组未见明显差异。结论高血糖合并冠心病患者血管内皮损伤较血糖正常冠心病患者更加明显，及早发现并积极控制血糖对于防止冠心病的发生发展具有重要意义。

Levers of von Willebrand factor, type 1 plasminogen activator inhibitor and adiponectin in coronary heart disease patients with hyperglycemia

Objective To investigate the levels of von Willebrand factor （vWF）, type 1 plasminogen activator inhibitor （PAI-1） and adiponectin in coronary heart disease patients with hyperglycemia. Methods Oral glucose tolerance test was carried out in the patients with coronary heart disease and different abnormal glucose metabolism, including diabetes mellitus（DM, n=44, 26.99%）, impaired glucose tolerance（IGT, n=59, 24.38%）, impaired fasting glucose（n=15, 7.46%） ; and 40 patients （24.54%）with normal glucose tolerance （NGT） as the control group. The level of vWF, PAI-1 and adiponectin was measured by ELISA for all these patients. Results vWF level increased in DM and IGT groups compared with NGT group, and showed significant statistical signiticance; PAI-1 level increased in DM group with statistical significance;adiponectin level of IGT and DM groups was higher than that of NGT group, and showed significant statistical signiticance. Conclusion Hyperglycemia causes high vWF and PAI-1 level, low adiponectin level, and leads to severe endothelial lesion. It is essential to discover and control hyperglycemia as early as possible to prevent the onset and development of coronary heart disease.