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为明确血浆纤溶酶原激活物抑制剂－１（ＰＡＩ－１）在ＮＩＤＤＭ发生冠心病中所起的作用，并分析其影响因素。将６０例ＮＩＤＤＭ患者分为冠心病（ＣＡＤ）组和非ＣＡＤ组，用底物发光法检测血浆ＰＡＩ－１及组织型纤溶酶原（ｔ－ＰＡ），同时检测血糖、血胰岛素、血脂等指标。结果表明：ＣＡＤ组血浆ＰＡＩ－１活性水平明显高于非ＣＡＤ组，分别为１０．０６±２．５与８．０８±２．６２，单位Ａｕ／ｍｌ，Ｐ＜０．０１。两组ｔ－ＰＡ相似。在ＣＡＤ组，血浆ＰＡＩ－１活性与空腹胰岛素、胰岛素敏感指数均相关，相关系数分别为０．２４（Ｐ＜０．０５）与－０．３（Ｐ＜０．０１），且与甘油三酯呈正相关（ｒ＝０．２４，Ｐ＜０．０５），和ＡｐｏＢ正相关（ｒ＝０．５１，Ｐ＜０．０５）。血浆ＰＡＩ－１活性水平的升高与ＮＩＤ－ＤＭ发生ＣＡＤ危险性存在相关。胰岛素抵抗状态、高胰岛素血症、高ＴＧ水平都可刺激血浆ＰＡＩ－１活性的升高，而高血糖对其无直接的作用。ＡｐｏＢ参与ＰＡＩ－１活性改变这一过程，并在ＣＡＤ发生中可能介导其它脂质异常刺激ＰＡＩ－１升高的作用。
In order to clarify the role of plasma plasminogen activator inhibitor-1 (PAI-1) in the pathogenesis of coronary heart disease in NIDDM, the influential factors were analyzed. Sixty patients with NIDDM were divided into coronary heart disease (CAD) group and non-CAD group. Plasma PAI-1 and tissue plasminogen (t-PA) were detected by substrate luminescence assay. Blood glucose, blood insulin, index. The results showed that plasma PAI-1 activity in CAD group was significantly higher than that in non-CAD group (10.06 ± 2.5 vs 8.08 ± 2.62, Au / ml, P <0.01). Two groups of t-PA similar. In the CAD group, plasma PAI-1 activity was correlated with fasting insulin and insulin sensitivity index, the correlation coefficients were 0.24 (P <0.05) and -0.3 (P <0.01) (R = 0.24, P <0.05), and positive correlation with ApoB (r = 0.51, P <0.05). Plasma PAI-1 activity levels associated with the risk of NID-DM CAD exist. Insulin resistance, hyperinsulinemia and high TG levels can stimulate the plasma PAI-1 activity increased, but no direct effect of hyperglycemia. ApoB is involved in the process of PAI-1 activity change and may mediate the effect of other lipid abnormalities on PAI-1 in CAD.