Bridges A B, McLaren M, Scott N A, Pringle T H, McNeill G P, Belch J J
University Department of Medicine, Ninewells Hospital and Medical School, Dundee.
Br Heart J. 1993 Feb;69(2):121-4. doi: 10.1136/hrt.69.2.121.
To determine whether plasma concentrations of tissue plasminogen activator antigen, von Willebrand factor antigen, and prostacyclin stimulating factor and plasminogen activator inhibitor activity show circadian variation in men with ischaemic heart disease.
Blood samples were obtained every four hours for 24 hours from 10 men with ischaemic heart disease. The men were ambulant from 08:10 until 00:00 when they went to bed and they remained in bed until 08:00 the following morning.
Ten men with positive diagnostic exercise tolerance tests with no significant past history, who were not regularly taking any medical treatment except for glyceryl trinitrate.
There was significant circadian variation in plasminogen activator inhibitor activity (p = 0.001) (peak value 04:00 and trough value 20:00), but not in plasma concentrations of tissue plasminogen activator antigen, von Willebrand factor, or prostacyclin stimulating factor.
Men with ischaemic heart disease showed a significant circadian variation in fibrinolysis. The combination of peak values of plasminogen activator inhibitor activity and failure of plasma concentrations of tissue plasminogen activator antigen to increase in the early morning must predispose to thrombosis at this time. The circadian variation in fibrinolysis may contribute to the increased incidence of myocardial infarction in the morning.
确定缺血性心脏病男性患者血浆组织型纤溶酶原激活物抗原、血管性血友病因子抗原、前列环素刺激因子浓度及纤溶酶原激活物抑制剂活性是否存在昼夜变化。
对10名缺血性心脏病男性患者进行24小时监测，每4小时采集一次血样。这些男性从08:10至00:00活动自如，00:00上床睡觉，直至次日08:00一直卧床。
10名男性，诊断性运动耐量试验呈阳性，既往无重大病史，除硝酸甘油外未规律服用任何药物。
纤溶酶原激活物抑制剂活性存在显著昼夜变化（p = 0.001）（峰值在04:00，谷值在20:00），但组织型纤溶酶原激活物抗原、血管性血友病因子或前列环素刺激因子的血浆浓度无昼夜变化。
缺血性心脏病男性患者的纤溶存在显著昼夜变化。纤溶酶原激活物抑制剂活性峰值与清晨组织型纤溶酶原激活物抗原血浆浓度未能升高相结合，必然会在此时诱发血栓形成。纤溶的昼夜变化可能导致早晨心肌梗死发病率增加。
