脑梗死患者血清脂蛋白(a)水平和纤溶系统活性的测定及相互关系  

Study on the relationship between the level of serum lipoprotein (a) and fibrinolytic function in patients with cerebral infarction

作　　者：刘晓红[1] 周维智[1] 林琳[1] 朱咏新[1] 

机构地区：[1]上海市普陀区人民医院神经内科,200060

出　　处：《中国脑血管病杂志》2004年第12期549-550,555,共3页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨脑梗死患者血清脂蛋白(a)水平、组织型纤溶酶原激活剂(t-PA)和纤溶酶原激活剂抑制物-1(PAI-1)活性的变化及它们之间的相互关系,研究脂蛋白(a)与缺血性脑血管病的关系。 方法 对137例急性脑梗死患者和54例健康者(对照组),采用速率散射比浊法检测血清脂蛋白(a)水平,发色底物法检测血浆t-PA与PAI-1活性,并进行比较。 结果脑梗死组血清脂蛋白(a)水平为(343±136)mg／L,血浆PAI-1活性为(896±97)AU／L,对照组血清脂蛋白(a)水平及PAI-1活性分别为(205±110)mg／L和(587±142)AU／L,两组比较差异有显著意义(P<0.01);脑梗死组t-PA活性为(223±77)IU／L,对照组为(424±121)IU/L,两组比较差异有显著意义(P<0.01)。脑梗死组血清脂蛋白(a)水平与t-PA活性呈显著负相关(r=-0.326,P<0.01),与PAI-1活性呈显著正相关(r=0.796,P<0.001)。结论脂蛋白(a)通过降低t-PA的活性和(或)增强PAI-1的活性,干扰纤溶系统的平衡,从而参与动脉粥样硬化过程。高脂蛋白(a)水平是缺血性脑血管病的重要独立危险因素。Objective To evaluate the changes of serum lipoprotein (a) level, plasma tissue plas-minogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) activity in patients with cerebral infarction, to explore their correlations and to further investigate the relationship between level of serum Lp (a) and ischemic cerebral vascular disease. Methods The levels of serum Lp (a) , plasma t-PAi and PAI-1 activity in 137 patients with acute cerebral infarction (CI) and 54 healthy control subjects were determined respectively by rate immunonephelometry and chrimogenic substrate method. All the results were compared. Results The mean level of serum Lp (a) and the activity of PAI-1 in the CI group [(343±136) mg/L and (896±97) AU/L respectively] were all obviously higher than those in the control group [(206±110)mg/L and (587±142) AU/L respectively] (P < 0.01) , while the activity of t-PA in the CI group [(223±77) IU/L] was obviously lower than that in the control group [(424±121) IU/L] (P<0.01) . The activity of t-PA was negatively related with the level of serum Lp (a) in the CI group (r= -0.326) , but PAI-1 was positively related (r= 0.796). Conclusion Lp (a) may interfere with the plasma fibrinolytic activity by influencing t-PA avtivity negatively and/or influencing PAI-1 activity positively, that may participate in the process of atherosclerosis and thrombosis. The high level of serum Lp (a) is an important and independent risk factor for cerebral infarction.

关 键 词：脑梗死 血清脂蛋白(a) 纤溶系统活性 PAI-1 脑血管 

分 类 号：R743.33[医药卫生—神经病学与精神病学]