Mitropoulos K A
MRC Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, Medical College, St Bartholomew's Hospital, London, UK.
Br Med Bull. 1994 Oct;50(4):813-32. doi: 10.1093/oxfordjournals.bmb.a072928.
Remnants produced on the lipolysis of triglyceride-rich lipoproteins provide a contact surface that activates the contact system of coagulation and therefrom factor VII. New evidence is reviewed suggesting that increased levels of circulating activated factor VII (VIIa) initiates coagulation and produces thrombin at higher rate at the site of an atheromatous lesion or at an injury site. This may have profound significance for the propagation of thrombus and for the thrombin-induced inflammatory and proliferative responses. Vascular homeostasis is achieved by the regulated interaction of the coagulation and fibrinolytic systems. An imbalance in this equilibrium may lead to an increased risk of thrombosis or a bleeding diathesis. The role of PAI-1, a potent inhibitor of enzymes that generate plasmin, in the regulation of fibrinolytic activity, is discussed and the evidence linking the expression of its activity to hypertriglyceridaemia is reviewed. Moreover, the association between lipoprotein (a) and coronary heart disease is attributed to its interference in the normal activation of plasminogen to plasmin.
富含甘油三酯的脂蛋白发生脂解作用时产生的残余物提供了一个接触表面，该表面可激活凝血接触系统并由此激活凝血因子VII。本文综述了新的证据，表明循环中活化凝血因子VII（VIIa）水平的升高会启动凝血，并在动脉粥样硬化病变部位或损伤部位以更高的速率产生凝血酶。这对于血栓的形成以及凝血酶诱导的炎症和增殖反应可能具有深远意义。血管稳态是通过凝血系统和纤溶系统的相互作用来实现的。这种平衡的失衡可能会导致血栓形成风险增加或出血倾向。本文讨论了纤溶酶原激活物抑制剂-1（PAI-1）在调节纤溶活性中的作用，PAI-1是一种产生纤溶酶的酶的有效抑制剂，并综述了将其活性表达与高甘油三酯血症联系起来的证据。此外，脂蛋白（a）与冠心病之间的关联归因于其对纤溶酶原正常激活为纤溶酶的干扰。
