Hamsten A, Wiman B, de Faire U, Blombäck M
N Engl J Med. 1985 Dec 19;313(25):1557-63. doi: 10.1056/NEJM198512193132501.
Certain risk factors for myocardial infarction have been linked with disturbances in fibrinolytic activity. The recent development in our laboratory of new sensitive and specific methods for determination of tissue plasminogen activator (t-PA) activity and antigen, as well as the discovery of a new rapid inhibitor of this enzyme, enabled us to study fibrinolytic function in detail in a representative population of postinfarction patients. Seventy-one patients (62 men and 9 women) who had survived a myocardial infarction before the age of 45 were compared with 50 healthy subjects of similar age, three years after the infarction. Low t-PA activity after venous occlusion, mostly explained by high plasma levels of the t-PA inhibitor and to some extent by impaired release of t-PA from the vessel wall, was a frequent finding in the patients. The level of t-PA inhibitor was positively and significantly correlated with levels of serum triglycerides. Our data suggest that reduced fibrinolytic capacity due to increased plasma levels of a rapid inhibitor of t-PA may have pathogenetic importance in myocardial infarction, particularly in patients with hypertriglyceridemia.
心肌梗死的某些危险因素与纤溶活性紊乱有关。我们实验室最近开发了新的灵敏且特异的方法来测定组织型纤溶酶原激活物（t-PA）的活性和抗原，并且发现了一种该酶的新型快速抑制剂，这使我们能够在有代表性的心肌梗死后患者群体中详细研究纤溶功能。将71例在45岁之前发生过心肌梗死且存活下来的患者（62名男性和9名女性）与50名年龄相仿的健康受试者在心肌梗死后三年进行比较。静脉闭塞后t-PA活性较低，这主要是由血浆中t-PA抑制剂水平较高所导致，在一定程度上也归因于血管壁释放t-PA的功能受损，这在患者中是常见现象。t-PA抑制剂水平与血清甘油三酯水平呈显著正相关。我们的数据表明，由于t-PA快速抑制剂的血浆水平升高导致纤溶能力降低，这可能在心肌梗死发病机制中具有重要意义，尤其是在高甘油三酯血症患者中。
