Brommer E J, Gevers Leuven J A, Barrett-Bergshoeff M M, Schouten J A
J Lab Clin Med. 1982 Jul;100(1):105-14.
Impairment of fibrinolysis is supposed to contribute to CVD. In 38 hyperlipoproteinemic patients, known to be at risk for early CVD, fibrinolytic activity was measured before and after stimulation with DDAVP. A negative correlation was found between serum triglyceride levels and fibrinolytic activity, both before and after DDAVP. A subnormal activity was invariably found when serum triglyceride concentration was above 8 mmol/L. The defect can be attributed to low levels of extrinsic plasminogen activator. High cholesterol levels were not associated with impairment of fibrinolysis. Fibrinolytic activity and response to DDAVP were lowest in those patients with hypertriglyceridemia who also had a tendency to develop hyperchylomicronemia. (type V/IV). The low fibrinolytic activity in this type of hyperlipoproteinemia cannot be explained by obesity. Factor VIII was higher than normal in most patients with hyperlipoproteinemia; the level increased after stimulation with DDAVP in every patient. This imbalance between coagulation and fibrinolysis might increase the risk of CVD.
纤维蛋白溶解功能受损被认为与心血管疾病(CVD)有关。在38名已知有早期CVD风险的高脂蛋白血症患者中,在使用去氨加压素(DDAVP)刺激前后测量了纤维蛋白溶解活性。在DDAVP刺激前后,血清甘油三酯水平与纤维蛋白溶解活性之间均发现呈负相关。当血清甘油三酯浓度高于8 mmol/L时,总是发现活性低于正常水平。这种缺陷可归因于外源性纤溶酶原激活剂水平较低。高胆固醇水平与纤维蛋白溶解功能受损无关。在那些同时有发展为高乳糜微粒血症倾向(V/IV型)的高甘油三酯血症患者中,纤维蛋白溶解活性和对DDAVP的反应最低。这种类型的高脂蛋白血症中纤维蛋白溶解活性低不能用肥胖来解释。大多数高脂蛋白血症患者的因子VIII高于正常水平;每位患者在使用DDAVP刺激后该水平均升高。凝血与纤维蛋白溶解之间的这种失衡可能会增加CVD的风险。