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高血压和糖尿病患者中脂蛋白(a)与其他血脂以及凝血和纤溶参数的低阶相关性。

Low order correlations of lipoprotein(a) with other blood lipids and with coagulation and fibrinolysis parameters in hypertensive and diabetic patients.

作者信息

Donders S H, Lustermans F A, van Wersch J W

机构信息

Department of Internal Medicine, De Wever Hospital, Heerlen, The Netherlands.

出版信息

Blood Coagul Fibrinolysis. 1992 Jun;3(3):249-56. doi: 10.1097/00001721-199206000-00003.

Abstract

Lipoprotein(a) (Lp(a)) has been established as an important independent risk factor for the development of cardiovascular disease. Apolipoprotein(a), together with apo B-100 the apolipoprotein of Lp(a), is homologeous to plasminogen but lacks fibrinolytic capacity and appeared to interfere with fibrinolysis in in vitro and ex vivo experiments. We determined the correlations between Lp(a) and other blood lipids (serum cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), coagulation parameters (fibrinogen, factor VII, factor VIII:C fibrin monomers, thrombin-antithrombin III) and fibrinolysis parameters (tissue plasminogen activator antigen, plasminogen activator inhibitor-1 and D-dimer) in 54 patients with essential hypertension, in 65 non-insulin-dependent diabetic patients and in 116 insulin-regulated diabetic patients. Signs of activated coagulation and increased reactive fibrinolysis were found in all three patient groups. In the hypertensive patients, Lp(a) was significantly correlated with LDL-cholesterol (r = 0.25, P = 0.04) and triglycerides (r = -0.30, P = 0.03), while in insulin-regulated diabetics, Lp(a) was also correlated with LDL-cholesterol (r = 0.20, P = 0.03). In the hypertensive patients and both diabetic groups there was no correlation of Lp(a) with coagulation or fibrinolysis parameters. These data show that Lp(a) concentrations are not related to coagulation or fibrinolysis parameters in hypertensive or diabetic patients and confirm the presence of an activated coagulation system in these patient groups.

摘要

脂蛋白(a) [Lp(a)] 已被确认为心血管疾病发生的一个重要独立危险因素。载脂蛋白(a)与Lp(a)的载脂蛋白apo B-100一起,与纤溶酶原同源,但缺乏纤溶能力,并且在体外和体内实验中似乎会干扰纤维蛋白溶解。我们测定了54例原发性高血压患者、65例非胰岛素依赖型糖尿病患者和116例胰岛素调节型糖尿病患者中Lp(a)与其他血脂(血清胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯)、凝血参数(纤维蛋白原、因子VII、因子VIII:C、纤维蛋白单体、凝血酶-抗凝血酶III)以及纤维蛋白溶解参数(组织纤溶酶原激活物抗原、纤溶酶原激活物抑制剂-1和D-二聚体)之间的相关性。在所有三组患者中均发现了激活凝血和反应性纤维蛋白溶解增加的迹象。在高血压患者中,Lp(a)与低密度脂蛋白胆固醇显著相关(r = 0.25,P = 0.04),与甘油三酯也显著相关(r = -0.30,P = 0.03);而在胰岛素调节型糖尿病患者中,Lp(a)也与低密度脂蛋白胆固醇相关(r = 0.20,P = 0.03)。在高血压患者以及两组糖尿病患者中,Lp(a)与凝血或纤维蛋白溶解参数均无相关性。这些数据表明,高血压或糖尿病患者的Lp(a)浓度与凝血或纤维蛋白溶解参数无关,并证实了这些患者组中存在激活的凝血系统。

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