Sakata K, Kurata C, Taguchi T, Hayashi H, Kobayashi A, Yamazaki N, Rydzewski A, Takada A
Third Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.
Eur Heart J. 1989 Dec;10(12):1118-22. doi: 10.1093/oxfordjournals.eurheartj.a059436.
A 67-year-old man had an acute myocardial infarction with thrombosis in the left anterior descending artery shortly after normal exercise. We were able to measure the fibrinolytic components in this patient just prior to his developing acute myocardial infarction as well as during convalescence. In this case, marked increase in total plasminogen activator inhibitor-1 (PAI-1) antigen, mainly due to free PAI-1 antigen, was observed in basal conditions before the onset of acute myocardial infarction. On the appearance of ischaemia, plasminogen activator activity was suppressed, probably due to decreased tissue plasminogen activator antigen release and increased PAI activity, compared with that during convalescence. This suggests that some patients with coronary artery disease who have a high level of free PAI-1 antigen in basal conditions may have a strong tendency to develop acute myocardial infarction, due to further impaired fibrinolysis on the induction of ischaemia.
一名67岁男性在正常运动后不久发生急性心肌梗死，左前降支动脉有血栓形成。我们能够在该患者发生急性心肌梗死之前以及康复期间测量其纤溶成分。在这种情况下，在急性心肌梗死发作前的基础状态下，观察到总纤溶酶原激活物抑制剂-1（PAI-1）抗原显著增加，主要是由于游离PAI-1抗原增加。与康复期间相比，出现缺血时，纤溶酶原激活物活性受到抑制，这可能是由于组织纤溶酶原激活物抗原释放减少和PAI活性增加所致。这表明，一些在基础状态下游离PAI-1抗原水平较高的冠心病患者，由于缺血诱导后纤溶功能进一步受损，可能有发生急性心肌梗死的强烈倾向。
