Chandler W L, Stratton J R
Department of Laboratory Medicine, University of Washington, Seattle 98195.
Am J Clin Pathol. 1994 Aug;102(2):248-52. doi: 10.1093/ajcp/102.2.248.
The aims of this study were to determine whether elevated plasminogen activator inhibitor type 1 (PAI-1) activity after myocardial infarction reflects baseline PAI-1 or represents an acute-phase response secondary to the infarction, and to determine how tissue plasminogen activator (t-PA) activity and total t-PA antigen levels in healthy control subjects differ from those in patients after myocardial infarction. Compared with healthy control subjects, patients studied 1-3 months after infarction had elevated levels of PAI-1 activity and fibrinogen but normal levels of C-reactive protein and von Willebrand factor antigen, whereas patients with a noncardiac acute-phase response showed elevation of all four proteins. Elevated PAI-1 activity in the absence of elevations in other acute-phase proteins suggests an intrinsic increase in PAI-1 secretion in the post-myocardial infarction group. In addition, when compared with healthy control subjects, post-myocardial infarction patients had higher levels of total t-PA antigen (bound and free t-PA) but lower t-PA activity and a lower percentage of active t-PA. Overall, survivors of myocardial infarction have reduced t-PA activity and increased PAI-1 activity that is not due to a prolonged acute-phase response.
本研究的目的是确定心肌梗死后纤溶酶原激活物抑制剂1（PAI-1）活性升高是反映基线PAI-1水平，还是代表梗死继发的急性期反应，并确定健康对照者的组织纤溶酶原激活物（t-PA）活性和总t-PA抗原水平与心肌梗死后患者的这些指标有何不同。与健康对照者相比，梗死1至3个月后接受研究的患者PAI-1活性和纤维蛋白原水平升高，但C反应蛋白和血管性血友病因子抗原水平正常，而有非心脏急性期反应的患者这四种蛋白均升高。在其他急性期蛋白未升高的情况下PAI-1活性升高，提示心肌梗死后组PAI-1分泌存在内在增加。此外，与健康对照者相比，心肌梗死后患者的总t-PA抗原（结合型和游离型t-PA）水平较高，但t-PA活性较低，活性t-PA的百分比也较低。总体而言，心肌梗死幸存者的t-PA活性降低，PAI-1活性升高，这并非由于急性期反应延长所致。
