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Hamostaseologie 1991; 11(04): 189-199
DOI: 10.1055/s-0038-1660302
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Schattauer GmbH

Fibrinolyse und Blutgerinnung bei ischämischer Herzerkrankung

Risikofaktoren und ihre Beziehung zur metabolischen Dysfunktion der Intima der Arterien
J. Jespersen
1   Sektion für Blutgerinnung und Fibrinolyse, Abteilung für Klinische Chemie, Ribe Kreiskrankenhaus in Esbjerg und Sektion für Thromboseforschung, Universität Südjütland, Esbjerg, Dänemark
,
S. Munkvad
1   Sektion für Blutgerinnung und Fibrinolyse, Abteilung für Klinische Chemie, Ribe Kreiskrankenhaus in Esbjerg und Sektion für Thromboseforschung, Universität Südjütland, Esbjerg, Dänemark
,
J. Gram
1   Sektion für Blutgerinnung und Fibrinolyse, Abteilung für Klinische Chemie, Ribe Kreiskrankenhaus in Esbjerg und Sektion für Thromboseforschung, Universität Südjütland, Esbjerg, Dänemark
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Publication Date:
26 June 2018 (online)

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Zusammenfassung

Dieser Bericht gibt einen Überblick über die mit der Entwicklung der ischämischen Herzkrankheit (IH) verbundenen Abweichungen der Hämostase und auch über solche Abweichungen, die für die Entwicklung des akuten ischämischen Herzsyndroms von Bedeutung sein könnten.

Es wird gezeigt, daß Abweichungen im t-PA/PAI-1-System auf eine endotheliale Dysfunktion bei Patienten mit IH hinweisen. Es werden 3 Mechanismen vorgestellt, die eine derartige Endothelzelldysfunktion auslösen könnten, d.s. erhöhte Insulinproduktion, erhöhte Produktion von Entzündungsmediatoren und erhöhte Thrombinproduktion.

Schließlich wird die enge Beziehung zwischen Gerinnung und Fibrinolyse bei Patienten mit IH diskutiert. Die besprochenen experimentellen und klinischen Studien liefern gute Beweise dafür, daß die Reaktionen von t-PA und PAI-1 in den Endothelzellen miteinander verbunden sind und daß eine enge Beziehung zwischen der Bildung von Thrombin und der Produktion bzw. Freisetzung von t-PA und PAI-1 mit der Endotheizellfunktion bei Patienten mit IH besteht..

 

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