纤维蛋白溶解活性动力图形分析及意义

目的 建立动态检测人纤维蛋白溶解功能的方法.方法 采用血凝-溶解法和发色底物法,应用Unico-20000分光光度计连接微机,动态监测血浆或优球蛋白凝溶或显色情况.结果 利用发色底物法测得20名正常人在显色180 s时的纤溶酶活性为(86.8±37.2)%,标准曲线有良好的线性相关(活性为3.9%～125%时r=0.978,7.8%～125%时r=0.997),22例糖尿病患者会出现各种纤维蛋白溶解活性生成异常图形,而大多数病例表现为纤维蛋白溶解活性增强.结论 应用血凝-溶解和发色底物法,以血浆或优球蛋白为检测标本,其结果更有利判断人体纤维蛋白溶解功能改变的性质,而且利用发色底物法以优球蛋白为检测标本较血浆更为敏感,上述方法可作为传统检测方法的补充.     

癌症与纤维蛋白溶解

肿瘤细胞要浸润周围组织并转移至远端器官就必须与组成基底膜和胞外间质的组分相粘附或反应,并以局部蛋白水解的方式通过宿主基质屏障。肿瘤细胞的蛋白水解活性主要是通过纤溶酶和纤溶酶原激活物等丝氨酸蛋白酶而集中作用于细胞表面。肿瘤细胞的分泌尿激酶型组织纤溶激活剂（ｕＰＡ）受体（ｕＰＡＲ：ＣＤ８７）可与周围肿瘤细胞或基质细胞所释放的ｕＰＡ相结合,该结合可在肿瘤细胞表面集中蛋白溶解活性［１］。ｐｒｏｕＰＡ,纤溶酶原（Ｐｌｇ）可与其相应受体结合［２,３］。ｐｒｏｕＰＡ被纤溶酶激活而形成具有酶活性的ｕＰＡ,…     

纤维蛋白（原）降解产物对用发色底物法测定抗凝血酶Ⅲ活性的影响

目的：探讨纤维蛋白（原）降解产物（FDP）、D－二聚体（D－D）对用发色底物法测定抗凝血酶Ⅲ活性（AT－Ⅲ：A)的影响。方法：留取31例体检正常和85例FDP、D－D可能增高的患标本，分别用发色底物法测定AT－Ⅲ：A，用免疫比浊法测定抗凝血酶Ⅲ抗原（AT－Ⅲ：Ag），用ELISA法测定其FDP、D－D含量。再将正常混合血浆与高FDP、D－D浓度的异常混合血浆、高D－D浓度的标准品以不同比例混合后，用上法分别测定其AT－Ⅲ：A及AT－Ⅲ：Ag、FDP、D－D的含量。结果：AT－Ⅲ：A除肝硬化组外其余各组与对照组比较均无显性差异，P＞0．05，而AT－Ⅲ：Ag含量各组均显低于对照组；AT－Ⅲ：A与AT－Ⅲ：Ag含量的比值均明显高于对照组，其比值增高的幅度与FDP、D－D的浓度呈正相关。结论：FDP、D－D会使发色底物法测定AT－Ⅲ：A结果偏高，其偏高的幅度与FDP、D－D的含量呈正相关，此时测定AT－Ⅲ：Ag含量更能反映其临床意义。     

烟酸的降血脂及促纤维蛋白溶解作用

烟酸属于水溶性维生素,在体内变成烟酰胺,参与体内多种代谢过程,并有扩张小血管降低胆固醇和甘油三酯的作用。 为了说明烟酸的降血脂作用,首先应了解血脂水平与动脉粥样硬化及冠心病的关系。几个以动脉粥样硬化性心脏病患者为对象的对照试验已经证实,低密度脂蛋白(LDL)胆固醇水平降低30％到40％不仅中等度降血管造影所显示的动脉硬化病变     

恶性血液病引起原发纤维蛋白溶解3例

目前文献报道弥漫性血管内凝血(DIC)引起的继发纤维蛋白溶解(简称：纤溶)较多，而对原发纤溶的存在表示怀疑，甚至认为所有纤维蛋白溶解都继发于DIC。笔者认为原发纤溶确实存在，应与继发纤溶相鉴别。原发纤溶诊断标准：①多部位出血；②血浆凝血酶原时间(PT)延长，激活的白陶土磷脂复钙试验时间(APTT)延长；③纤维蛋白原(Fg)降低；④纤     

血浆纤维蛋白溶解系统与膀胱肿瘤

纤溶系统与恶性肿瘤有密切的相关性。一系列的临床观察和实验研究证实了恶性肿瘤与止、凝血功能改变关系密切 ,本文试图对膀胱肿瘤的发生、发展及恶性度与纤溶系统的相关性加以探讨。1　材料和方法1 1　测定对象　膀胱肿瘤患者 40例 ,男 32例 ,女 8例 ,年龄34ｙ～ 73ｙ。为首次发病 ,测试前未进行任何抗肿瘤治疗。均经ＩＶＰ、Ｂ型超声、ＣＴ和膀胱镜检查确诊。病理学诊断 :膀胱移行细胞癌 ,Ⅰ级 2 7例 ,Ⅱ～Ⅲ级 13例 ,非肿瘤患者 5 4例 ,男 36例 ,女 18例 ,年龄 19ｙ～ 80 ｙ。经ＩＶＰ、Ｂ超、ＣＴ检查排除身体各部位恶性肿瘤。1 2　方法…     

尖吻蝮蛇毒纤维蛋白溶解活性组分的纤溶作用

采用ＤＥＡＥ－Ｓｅｐｈａｒｏｓｅ ＣＬ－６Ｂ离子交换色谱，Ｕｌｔｒｏｇｅｌ ＡｃＡ４４凝胶过滤色谱和ＦＰＬＣ快速蛋白色谱，从湖南产尖吻蝮蛇毒中分离，提取出一种纤维蛋白溶解活性组分。采用＾１２５Ｉ标记纤维蛋白原制成血凝块的方法，对此组分体外溶栓效果进行观察，同时测定了该组分在血浆中水解纤溶酶的特异底物Ｓ－２２５１的活力及纤维蛋白原含量的变化。结果表明，湖南产尖吻蝮蛇毒纤维蛋白溶解活性组分的体外有明显     

急性颅脑损伤后的纤溶变化及其临床意义

目的探讨急性颅脑损伤后的纤溶变化及其临床意义。方法动态观察 75例急性颅脑损伤患者血浆中的纤溶酶、纤溶酶原激活剂抑制和D 二聚体 ,结合临床进行不同的分组比较分析。结果伤后 2 4小时内 3项纤溶指标的检测结果与对照组、伤后 7天、14天比较均有非常显著的差异 ;按伤情轻重、预后以及有无迟发颅内出血进行分组比较 ,差异均具有统计学意义 ;D 二聚体的异常率最高。结论急性颅脑损伤的早期可出现明显的纤溶异常 ,它对判断脑实质损伤程度及迟发颅内出血的发生具有参考价值 ,当D 二聚体血浆水平≥ 8mg/L时 ,可作为预后险恶的指标     

高血压合并急性脑梗死患者测定凝血、抗凝和纤溶指标的临床意义

目的分析高血压病及合并急性脑梗死患者凝血、纤溶系统分子标志物指标的变化及意义,为临床早期诊治提供客观依据。方法检测100例高血压病患者、100例高血压病合并急性脑梗死患者及100名健康对照者血浆内皮素-1(ET-1)、血小板α-颗粒膜蛋白(GMP-140)、11-去氢血栓烷B2(11-DH-TXB2)、纤维蛋白原(FIB)、组织型纤溶酶原激活剂(t-PA)及纤溶酶原激活剂抑制物-1(PAI-1)含量,并进行分析与评价。结果高血压病患者、高血压病合并急性脑梗死患者血浆ET-1、GMP-140、11-DH-TXB2、FIB、t-PA、PAI-1含量均明显高于正常对照者,差异有统计学意义(P<0.01)。结论高血压病患者存在明显的凝血及纤溶功能失衡,这与其病情进展、急性脑梗死的发生密切相关,早期检测、早期防治具有重要的临床意义。     

二期发色底物法外周血单核细胞促凝活性测定

以国产标化组织凝血活酶为代标准液，依据外源凝血途径建立反应系统。ＦＡａ水解发色底物释放硝基苯胺，于４０５ｎｍ测定所得的吸光度与标准液中组织凝血活酶含量呈良好的双对数线性关系（ｒ＝０．９９８），此方法测定范围在１￣１０＾３凝血活酶单位之间；标准曲线的重复性好（ＣＶ＝５％），经ＰＢＭＣ标本测定显示，应用本方法检测ＰＢＭＣ ＰＣＡ符合实验要求。     

冠心病患者凝血、纤溶指标变化及其临床意义

目的 探讨冠心病患者凝血纤溶指标的变化特点.方法 选择25名冠心病稳定性心绞痛患者和16例健康体检者,分别检测两组人群凝血纤溶动态图和凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(Fbg).结果 冠心病患者凝血纤溶动态图中凝固时间缩短,血浆Fbg含量明显升高.结论 冠心病患者血液呈高凝和继发纤溶亢进状态,具有形成血栓可能性.     

超重及肥胖者凝血、抗凝血、纤溶指标的变化及意义

目的　观察超重及肥胖者凝血、抗凝血、纤溶指标的变化 ,探讨其增加心血管危险的机制。方法　对10 5名超重者和 10 3名肥胖者 ,取清晨空腹抗凝血 ,用酶联免疫吸附试验 (ELISA)测定血浆血管性血友病因子(vWF)、P 选择素含量 ;用发色底物法进行抗凝血酶 (AT)、组织型纤溶酶原激活剂 (t PA)、组织型纤溶酶原激活剂抑制剂 (PAI)活性测定 ;用凝固法进行纤维蛋白原 (Fbg)测定。 结果　超重组和肥胖组vWF、P 选择素、Fbg、PAI水平均显著高于对照组 (P <0 .0 5～ 0 .0 1) ,且与体重指数及所伴危险因素 (高血脂、高血压、高血糖 )数量显著相关。超重组AT、t PA活性与对照组差异无显著性 (P >0 .0 5 ) ,而肥胖组显著降低 (P <0 .0 5 )。结论　超重及肥胖者存在凝血功能亢进、抗凝血及纤溶功能减退 ,这种变化可能是增加心血管危险的主要原因     

Intrapericardial fibrinolysis: a useful treatment in the management of purulent pericarditis

Since the introduction of antibiotics into clinical practice, purulent pericarditis has become a rare disease. The major complication of the standard management for this condition is constrictive pericarditis. We report two cases of purulent pericarditis in which intrapericardial fibrinolysis was performed in order to minimize this complication. The first case was a 38-year-old man admitted to our intensive care unit (ICU) for management of constrictive pericarditis complicating purulent pericarditis diagnosed 17 days previously. The patient was treated with four intrapericardial injections of streptokinase (250000 IU each). Fluid drainage and cardiac output were improved. No change in clotting parameters was noted. Pericardiectomy and esophagectomy were then performed for a diagnosis of esophageal neoplasm. The postoperative course was uneventful. The second case was a 16-year-old boy admitted with loss of consciousness due to cardiac tamponade. Percutaneous pericardiocentesis drained 900 ml of cloudy fluid. Two intrapericardial injections were performed (day 1 and day 5) without any complication. Pericardial drainage was withdrawn on day 13 and the patient was discharged from ICU on the same day. Six months later, there was no evidence of constrictive pericarditis. Intrapericardial fibrinolysis appears to be safe and effective when prescribed rapidly in the course of purulent pericarditis. Received: 19 June 1996 Accepted: 15 September 1996     

Tissue fibrinolysis in experimental gastric ulcer: a study in the rat

Abstract. Gastric mucosal lesions were induced in rats by pyloric ligature and intragastric instillation of hydrochloric acid. Within 4 h all rats developed focal mucosal lesions. Early regeneration was observed 72 h after release of the pyloric ligature and replacement of the hydrochloric acid by a phosphate buffer. A significantly increased gastric mucosal fibrinolytic activity was found 4 h after pylorus ligation. The submucosal vascular fibrinolysis remained unchanged. Following release of the pyloric ligature the increased mucosal fibrinolysis returned to normal values after 72 h. Intravenous administration of tranexamic acid significantly decreased the mucosal and vascular fibrinolytic activity without influencing the formation of induced gastric lesions. Increased mucosal fibrinolysis is probably not involved in the development of mucosal lesions.     

原位肝移植术中抗凝及纤溶功能变化的初步研究

目的研究原位肝移植术(OLT)中的抗凝与纤溶功能的改变。方法对14例肝病患者施行肝移植手术中抗凝及纤溶系统的功能进行了系统的观察。结果发现在OLT术中,抗凝系统活性经历从升高到降低,随后重新升高的过程。纤溶系统随手术进行而加强,并且在重新灌注5min和灌注1h时达到最高点。结论准确及时地监测肝移植过程中止凝血及纤溶功能的变化是进行有效调控出凝血平衡的重要手段。     

Impaired fibrinolysis determines the outcome of percutaneus transluminal coronary angioplasty (PTCA)

BACKGROUND: Coronary artery stenosis lesions dilated by percutaneus transluminal coronary angioplasty (PTCA) show a disappointingly frequent recurrence of stenosis. We have investigated the possible role of fibrinolysis and various platelet-release factors - specifically in the locality of the affected vessel - by following 19 patients for 6 months after PTCA. METHODS: PTCA was performed on 19 patients with a significant primary coronary stenosis, proven by quantitative CAAS analysis. Blood for measurement of local fibrinolysis and platelet activity was drawn from the aortic root and the coronary sinus, at three times: just before PTCA, 10 min after it, and 6 months later. RESULTS: The incidence of restenosis at the 6 months follow-up was 37%. PTCA almost doubled the platelet-derived growth factor level (PDGF) in coronary sinus blood in all patients. The seven restenosis patients had a substantially higher tissue plasminogen activator inhibitor antigen (PAI-1ag) level in the aortic root before PTCA than the 12 who remained stenosis-free (mean 62.4 +/- 31.6 ng mL -1 compared with 33.1 + 25.3; P < 0.04) and a lower tissue plasminogen activator activity (t-PAac) level (mean 0.32 +/- 0.19 IU mL-1 compared with 0.68 +/- 0.34; P < 0.03). This was corroborated by the levels of tissue plasminogen activator inhibitor activity (PAI-1ac). At reassessment after 6 months, the restenosis patients had developed, in coronary sinus blood, a large rise of PAI-1ac (7.7 +/- 4.8 IU mL-1 rising to 15.7 +/- 13.9, P < 0.04) and a large rise of of PAI-1ag (48.8 +/- 31.3 ng mL-1 vs. 72.4 +/- 47.2; P < 0.03). But no such increase occurred in the patients who remained stenosis-free. Conclusion Our results indicate that the minor balloon injury, which is inseparable from PCTA, stimulates the local release of PDGF. We suggest that, in those patients whose fibrinolytic activity is inherently low, this rise of PDGF could be a major causative factor in restenosis. We also discuss the possibility that the preoperative level of PAI-1ac could provide a limited but useful prediction of the outcome of PTCA.