| There is evidence that high plasma plasminogen activitor inhibitor-1 (PAI-1) concentration is associated with the progression of coronary heart disease (CHD) and the development of myocardial infarction. The PAI-1 is a linear glycoprotein that is composed of 379 amino acids and has a molecular weight of 48,000. It binds rapidly to tissue type plasminogen activator (t-PA) and to urinary-type plasminogen activator, forming a stable complex with a ratio of 1:1 that is cleared from the circulation by hepatic cells. The active form of PAI-1 is unstable, with a half-life of 30 minutes. Activated PAI-1 is the form synthesized in platelets as well as endothelial cells. PAI-1 is recognized as the most important physiological inhibitor in fibrinolytic system. Most studies indicated that plasma PAI-1 content is different between the patients with CHD and normal subjects ,as well as among the stable angina pectoris, unstable angina pectoris, and acute moyocardial infarction. But some studies got the different results. Some studies found that the ordinary operation can increase the activity of plasma PAI-1 temporarily. While the angiotensin converting enzyme inhibitors(ACEI) can decrease the content of the plasma PAI-1. However, few studies have focused to study the effect of regular drug on the plasma PAI-1 in patients with coronary heart disease,and many questions about PAI-1 are disputed. In this thesis ,we studied the relationship between PAI-1and CHD and it's related clinical factors.1,The relationship between PAI-1and CHDObjective:To study the changes of the plasma PAI-1 content in the patients with or without coronary heart disease. Method: 294 patients (50-75 years old) who were come to Changhai hospital for coronary angiography from Februry 2003 to October 2003 were enrolled in this study.The patients with coronary heart desease were divided into stable angina pectoris(SAP) and unstable angina pectoris(UAP). The plasma PAI-1,t-PA contents were measured with enzyme-immunoassay.The plasma C reactive protein( CRP) was measured with latex agglutination. Results: The content of PAI-1(A:28.38±12.37 vs C:34.14±14.83 ng/ml, p<0.05),t-PA(A:8.36±8.10 vs C:12.82±9.85 ng/ml, p<0.01) and CRP(A:4.89±11.02 vs C:13.83±19.52 mg/L, p<0.05) in UAP group were significantly higher than those in the normal groups.However, the differences of PAI-1,t-PA and CRP between SAP group and the normal group, SAP group and the UAP group were not statistical significant. Conclusion:The plasma content of PAI-1,t-PA,CRP increased in UAP patients, but not in SAP patients, indicating that the plasma PAI-1 may contribute to the progress of the coronanry heart desease .2,The effects of select percutanous transluminal coronary intervension(PCI) on plasma PAI-1 content in patients with coronary heart disease.Objective: To investigate the effects of PCI on plasma PAI-1 content in patients with coronary heart disease. Forty-eight patients underwent PCI were enrolled in this study, before the operation, all the patients were given aspirin 300mg,qd ; ticlopidin 250mg bid.After the operation, low molecular weight heparin fraxiparine 0.4ml was given subcutanously to each patient twice a day for six days.The patients received optimal treatment include ACE inhibitors,nitrates and statins. The blood samples were taken before PCI, and in the first day ,the third day and the sixth day after PCI. PAI-1,t-PA,CRP were measrued as before. Results: The content of CRP increased significantly in the first day(9.96±14.67 vs 12.75±9.91 mg/L,p<0.05) , reached it's peak in the third day(16.11±21.37 mg/L,p<0.05),and returned to normal in the sixth day. The plasma levels of t-PA and PAI-1 didn't change significantly. Conclusion: PCI had no significantly influence on the plasma PAI-1 and t-PA. The probable reason may be the effects of anti-platelet drugs and heparin on the plasma content of PAI-1 and t-PA.3,The changes of plasma PAI-1 in patients with acute myocardial infarction(AMI) and the effect of fraxiparine on it .Objective:To study...
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