成瘾性冠状动脉疾病患者的血清1型纤溶酶原激活物抑制剂水平。
Serum level of plasminogen activator inhibitor type-1 in addicted patients with coronary artery disease.
作者信息
Forood Afsaneh, Malekpour-Afshar Reza, Mahdavi Amin
机构信息
Assistant Professor, Physiology Research Center, Department of Cardiology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Associate Professor, Neuroscience Research Center, Department of Pathology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
出版信息
Addict Health. 2014 Summer-Autumn;6(3-4):119-26.
BACKGROUND
Plasminogen activator inhibitor-1 (PAI-1) is a glycoprotein with inhibitory effects on the formation of plasmin from plasminogen by plasminogen activator. Thus, it prevents clot lysis in vessel walls. Several evidences prove the relationship between coronary artery disease and response to fibrinolytic therapy in patients with myocardial infarction (MI) with PAI-1 level. Opium addiction is one of the most important factors in causing MI and cardiovascular events. This is due to it causing imbalance between coagulation and anticoagulation factors in the blood. This study was designed and implemented to determine the levels of PAI-I in opium-addicted patients with coronary artery disease in comparison with non addicts.
METHODS
In this case-control study, 160 patients with coronary heart disease (CHD), which was confirmed by angiography results, were enrolled. All of the patients had a medical history, their creatinine levels and lipid profile were evaluated, morphine urine test was performed, and after that a blood sample was taken to determine the levels of PAI-1. Thus, the 80 patients who had a positive morphine urine test result formed the case group, and the control group was constituted of the 80 patients with negative morphine test results. The two groups were matched.
FINDINGS
Average level of PAI-1 in the control group was 2.4 ± 2.6 and in the case group was 8.8 ± 9.1 and it was statistically significant (P < 0.001). The frequency of two vessel disease was higher in opium addicted patients than non-addicted patients and this was statistically significant (P = 0.030). However, the frequency of single vessel and three vessel disease was the same in the two groups. The two groups had no differences in age, lipid profile, and creatinine level. Moreover, females are at a higher risk of high PAI-1 levels.
CONCLUSION
PAI-1 levels in opium addicted patients with CHD are higher than other patients. In these patients, the risk of atherosclerosis and MI is higher than normal.
背景
纤溶酶原激活物抑制剂-1（PAI-1）是一种糖蛋白，对纤溶酶原激活物将纤溶酶原转化为纤溶酶的过程具有抑制作用。因此，它可防止血管壁内的血栓溶解。多项证据证实了冠状动脉疾病与心肌梗死（MI）患者纤溶治疗反应及PAI-1水平之间的关系。鸦片成瘾是导致MI和心血管事件的最重要因素之一。这是因为它会导致血液中凝血和抗凝因子失衡。本研究旨在确定与非成瘾者相比，鸦片成瘾的冠心病患者的PAI-1水平。
方法
在这项病例对照研究中，纳入了160例经血管造影结果证实患有冠心病（CHD）的患者。所有患者均有病史，评估其肌酐水平和血脂谱，进行吗啡尿液检测，之后采集血样以测定PAI-1水平。因此，吗啡尿液检测结果呈阳性的80例患者组成病例组，对照组由80例吗啡检测结果为阴性的患者组成。两组进行了匹配。
结果
对照组PAI-1的平均水平为2.4±2.6，病例组为8.8±9.1，差异具有统计学意义（P<0.001）。鸦片成瘾患者双支血管病变的发生率高于非成瘾患者，且具有统计学意义（P=0.030）。然而，两组单支血管和三支血管病变的发生率相同。两组在年龄、血脂谱和肌酐水平方面无差异。此外，女性PAI-1水平升高的风险更高。
结论
鸦片成瘾的冠心病患者的PAI-1水平高于其他患者。在这些患者中，动脉粥样硬化和MI的风险高于正常水平。
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