体内、外血小板活化时血浆11-去氢-血栓烷B2的改变及其意义

目的和方法：用花生四烯酸（ＡＡ）诱导正常人（ｎ＝１２）富血小板血浆（ＰＲＰ）血小板活化。结果：ＡＡ组、消炎痛＋ＡＡ组及对照组血浆１１－去氢－血栓烷Ｂ２（ＤＨ－ＴＸＢ２）浓度分别为：（５１±２５、５．０±２．８及５４±３２）ｎｇ／Ｌ，三组之间无显著差别；但ＡＡ组ＴＸＢ２与Ｐ－选择素浓度均较对照组显著升高（Ｐ＜００１），消炎痛对两者的升高有几乎完全的抑制作用。２０例急性期脑梗塞患者血浆ＤＨ－ＴＸＢ２浓度（１０８～５５０ｎｇ／Ｌ）远高于对照组（１０～９３ｎｇ／Ｌ），无重叠，但两组之间ＴＸＢ２与Ｐ－选择素浓度均有５０％左右重叠。另６例患者服用９００ｍｇ阿司匹林后血浆ＤＨ－ＴＸＢ２下降４３％（Ｐ＜００１），但服药前后ＴＸＢ２及Ｐ选择素浓度无显著改变。结论：ＤＨ－ＴＸＢ２作为ＴＸＢ２的体内主要酶代谢产物，是反映体内血小板活化的一个较好的指标     

一氧化氮对家兔冠状动脉阻塞后血小板活化的影响

将３０只兔分为３组，Ｉ组行左冠状动脉前降支假扎，Ⅱ组及Ⅲ组行ＬＡＤ线线缝扎３０ｍｉｎ后再灌注４ｈ。Ⅲ组于ＬＡＤ结扎后静滴硝酸甘油，Ⅰ，Ⅱ组静滴生理盐水。３组均观察手术前后各时点血浆一氧化氮，血小板表面α颗粒膜蛋白，血栓素Ｂ２浓度。结果显示，Ⅰ组手术前后血浆ＮＯ，ＧＭＰ－１４０，ＴＸＢ２浓度无变化，Ⅱ，Ⅲ组在心肌缺血及再灌注后ＮＯ浓度降低，ＧＭＰ－１４０和ＴＸＢ２浓度升高，Ⅱ组上述变化更为显著。     

过敏性紫癜患者血浆GMP－140、cAMP、cGMP、IgG和IgA水平的研究

采用放射免疫法（ＧＭＰ－１４０用单位点免疫放射法）测定过敏性紫癜患者治疗前（ｎ＝２１）后（ｎ＝１９）血浆α－颗粒膜蛋白（ＧＭＰ－１４０）、环磷酸腺苷（ｃＡＭＰ）、环磷酸鸟苷（ｃＧＭＰ）、免疫球蛋白Ｇ和Ａ（ＩｇＧ、ＩｇＡ）含量，以３１例健康人作对照．结果，患者与对照比较，血浆ＧＭＰ－１４０（７５４±１６８分子数／血小板，Ｔ＝２．２９５，Ｐ＜０．０５），ｃＡＭＰ（１９．８９±７．９２对１４．２６±５．６３ｎｍｏｌ／Ｌ，Ｔ＝２．９９９，Ｐ＜０．０１），ｃＧＭＰ（４．８７±２．６２对３．４１±１．６９ｎｍｏｌ／Ｌ，Ｔ＝２．４４６，Ｐ＜０．０５），ＩｇＧ（１５．７５±５．５４对１１．４５±４．８６ｇ／Ｌ，Ｔ＝２．９５８，Ｐ＜０．０１）和ＩｇＡ（１．６８±０．８７对１．１６±０．５２ｇ／Ｌ，Ｔ＝２．６９８，Ｐ＜０．０１），且ｃＡＭＰ和ｃＧＭＰ水平升高呈正相关（ｒ＝０．４６９，Ｐ＜０．０５）。过敏性紫癜患者临床治愈后上述物质血浆含量下降，与对照比较无差异（Ｐ＞０．０５）．提示过敏性紫癜患者血浆ＧＭＰ－１４０、ｃＡＭＰ、ｃＧＭＰ、ＩｇＧ和ＩｇＡ可明显升高，临床治愈后恢复正常。     

冠心病患者血浆氧化修饰低密度脂蛋白、内皮素和α-颗粒膜蛋白水平变化的研究

通过对１０１ 例冠心病患者血浆氧化修饰低密度脂蛋白（ＯＸ－ ＬＤＬ） ,血浆内皮素（ＥＴ）和血小板α－ 颗粒膜蛋白（ＧＭＰ－ １４０） 水平变化的研究, 探讨动脉粥样硬化（ＡＳ） 形成的机制, 为冠心病的预防、早期诊断、治疗提供理论依据。采用抗ＯＸ－ ＬＤＬ单克隆抗体, 酶标多克隆抗体夹心和放射免疫分析的方法, 对血浆中ＯＸ－ ＬＤＬ、ＥＴ、ＧＭＰ－ １４０ 水平进行分析。结果显示除隐匿型外, 对照组与冠心病组之间的比较和冠心病组各型之间的比较, 血浆中ＯＸ－ ＬＤＬ、ＥＴ、ＧＭＰ－１４０ 水平均有显著差异（ Ｐ＜ ０ ．００１ 或Ｐ＜ ０ ．０１） ;测定三项指标其波动范围及ＯＸ－ ＬＤＬ／ＥＴ、ＧＭＰ－ １４０／ＥＴ的比值分析, 前者以隐匿型和心肌梗塞型最显著（２ ．２７ ,１ ．２３）,后者以心肌梗塞和心绞痛最明显（０ ．７１ ,０ ．７５） 。由此认为： ＯＸ－ ＬＤＬ、ＥＴ　ＧＭＰ－ １４０ 参与了ＡＳ的发生发展, 为冠心病的预防,早期诊断、治疗提供了理论依据。     

梗阻性黄疸患者血浆TXB2,6—K—PGF1αRIA

本文采用放射免疫分析法检测６４例梗阻性黄疸病人（服消炎痛组ｎ＝３２，未服消炎痛组ｎ＝３２）手术前后外因浆血栓素Ａ２和前列环素（ＰＧＩ２）的稳定代谢产物ＴＸＢ２和６－Ｋ－ＰＧＦ１α浓度２，结果表明，未服消炎痛组术前血浆ＴＸＢ２、６－Ｋ－ＰＧＦ１α浓度及Ｔ／Ｐ显著升高，尤以ＴＸＢ２升高明显（Ｐ〈０．０１）。术后血浆ＴＸＢ２、６－Ｋ－ＰＧＦ１α下降，但ＴＸＢ２仍高于无黄疸组水平，Ｔ／Ｐ无明显变化（Ｐ〉０     

慢性阻塞性肺病患者血浆血栓素B_2和6－酮－前列腺素F_（1α）含量的变化及其与肺动脉高压的关系

为了探讨慢性阻塞性肺病（ＣＯＰＤ）患者血栓素Ａ_２（ＴＸＡ_２）和前列环素（ＰＧＩ_２）与肺动脉高压的关系，我们对伴有和不伴有肺动脉高压的３０例缓解期ＣＯＰＤ患者血浆中血栓素Ｂ_２（ＴＸＢ_２）及６－酮－前列腺素Ｆ_（１α）（６－ｋｅｔｏ－ＰＧＦ_（１α））的含量变化进行了观察，还对７例伴肺动脉高压的ＣＯＰＤ患者不同病期的肺动脉平均压（ＰａＰ）、血浆ＴＸＢ_２及６－ｋｅｔｏ－ＰＧＦ_（１α）．水平作了对比分析。结果发现，缓解期ＣＯＰＤ患者中，伴肺动脉高压者血浆ＴＸＢ_２明显增高，６－ｋｅｔｏ－ＰＧＦ_（１α）显著下降，ＴＸＢ_２／６－ｋｅｔｏ－ＰＧＦ_（１α）明显增大，与不伴肺动脉高压者比较，差异非常显著（Ｐ均＜０．０１），而不伴肺动脉高压者的这些指标与正常人的比较，则无统计学意义（Ｐ均＞０．０５）；与急性期比较，ＣＯＰＤ患者缓解期ＰａＰ明显下降，ＴＸＢ_２亦显著降低，６－ｋｅｔｏ－ＰＧＦ_（１α）明显升高，ＴＸＢ_２／６－ｋｅｔｏ－ＰＧＦ_（１α）缩小（Ｐ均＜０．０１）；相关分析发现，伴肺动脉高压者ＰａＰ与ＴＸＢ_２呈明显正相关，与６－ｋｅｔｏ－ＰＧＦ_（１α）呈负相关（ｎ＝２８，ｒ＝＋０．４６、－０．３９，Ｐ均＜０．０５）     

Iloprost对内皮细胞抗血栓功能的影响

以体外培养的猪主动脉内皮细胞（ＥＣ）为模型研究Ｉｌｏｐｏｓｔ对ＥＣ抗血栓功能的影响。用放免法、发色底物法测定培养液中６－酮－ＰＧＦ１α（６－ｋｅｔｏ－ＰＧＦ１α），血栓素Ｂ２（ＴＸＢ２）含量，纤溶酶原激活物（ＰＡ），纤溶酶原激活物抑制物（ＰＡＩ）活性及ＥＣ环磷酸腺苷（ｃＡＭＰ）含量。结果表明：Ｉｌｏｐｒｏｓｔ中以使ＥＣ生成６－ｋｅｔｏ－ＰＧＦ１α，ｃＡＭＰ含量显著增多，ＴＸＢ２含量显著减少，并使Ｐ     

实验性犬心肌梗塞和溶栓后再闭塞时血浆中GMP—140,TXB2的变化

本文采用放免法测定实验性犬心肌梗塞和溶栓后再闭塞时血浆中ＧＭＰ－１４０、ＴＸＢ２、６－Ｋ－ＰＧＦ１α的含量变化，并探讨其与心肌梗塞溶栓后再闭塞的关系。结果表明，在血栓形成时血浆中ＴＸＡ２稳定代谢产物ＴＸＢ２水平显著升高（ｐ〈０．０５），在溶栓后再闭塞率高（８７．５％）的非治疗组（Ｂ组）。在溶栓后４小时至溶栓后３天期间呈进行性升高（ｐ〈０．０１），而在再 埘经低（１６．７％）的ＡＰＩ０１３４治疗组（     

失血性休克再灌注损伤时血浆磷脂酶A2及其水解产物的变化

目的和方法：采用家兔失血性休克／再灌注（Ｓ／Ｒ）模型，以放射免疫法分析了动物血清中磷脂酶Ａ２及其活性产物血栓素（ＴＸＢ２）、前列环素（ＰＧＩ２）在损伤过程中的变化规律，同时观察了氯喹及其同类化合物磷酸萘酚喹、抗氧化剂黄芪酮对Ｓ／Ｒ损伤后上述ＰＬＡ２活性产物的影响。结果：氯喹可明显降低ＰＬＡ２，使ＴＸＢ２／ＰＧＩ２比值恢复于接近正常；磷酸酚喹和黄芪酮也可明显降低ＰＬＡ２，使ＴＸＢ２／ＰＧＩ２比值显著低于Ｓ／Ｒ损伤组：ＨＣＯ－３和ｔＣＯ２也得以接近于正常水平。结论：Ｓ／Ｒ过程中ＴＸＢ２的增高导致的ＴＸＢ２／ＰＧＩ２比值改变可能对循环有重要影响；氯喹类化合物及环氧化物酶抑制剂可能通过抑制ＰＬＡ２活性及降低ＴＸＢ２／ＰＧＩ２比值，促进全身循环和呼吸系统功能恢复正常     

犬急性心肌缺血对内源性纤溶功能的影响

用缩窄犬冠脉致急性心缺血动物模型，动态观察血浆纤维蛋白原，组织型纤溶酶原激活剂及其抑制物、血栓素Ｂ２，６－酮前列纱Ｆ１级血浆肾素活性、血管紧张素Ⅱ水平的变化。结果表明：ＡＭＩ１５ｍｉｎ后，血浆ＰＡＩ、ＴＸＢ２及ＡＮＧⅡ水平随缺血时间延长逐渐渐增加。６０ｍｉｎ高峰，３０ｍｉｎ时血浆ｔ－ＰＡ活性水平开始降低，６０ｍｉｎ达低峰值，；６０ｍｉｎ后，血浆Ｆｅ及ｔ－ＰＡ含量显著增加，提示ＡＭＩ可能主要通过激活     

Plasma tissue plasminogen activator and plasminogen activator inhibitor-1 levels in acute myocardial infarction

The cause of the circadian variation in the incidence of acute myocardial infarction (AMI) has not been identified. Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) have opposing effects on thrombi. Hence, the extent of the clot, the size of the infarct and outcome of patients could depend on t-PA and PAI-1 levels. In an effort to elucidate the pathophysiologic basis of circadian variation of AMI, we investigated the presence of a possible corresponding circadian variation in the levels of endogenous t-PA and PAI-1 in patients diagnosed to have AMI and the effects of hypertension, diabetes and site of the infarct on these levels. We estimated the levels of t-PA and PAI-1 in platelet-poor plasma of 42 patients with AMI on admission, using the enzyme-linked immunosorbant assay. Although not statistically significant, patients having an AMI in the morning hours had the highest t-PA:PAI-1 ratio. The normal circadian variation in PAI-1 levels was lost in patients with AMI, probably due to the disease process. Also, the t-PA levels in hypertensive patients were significantly lower than in nonhypertensives. PAI-1 levels were also significantly lower in patients with anteroseptal than in inferior and anterolateral AMI. This relationship between the fibrinolytic potential and the site of infarction needs further study. Furthermore, t-PA levels on admission were significantly lower in survivors and may have a predictive value in determining the outcome.     

Tissue plasminogen activator, plasminogen activator inhibitors, and activator-inhibitor complex in liver disease.

AIMS--To identify the relative contribution of plasminogen activators, particularly tissue plasminogen activator (t-PA) and specific plasminogen activator inhibitors (PAI-1, PAI-2), to the fibrinolytic changes associated with various types of liver disease or severe chemical and physical damage to the liver. METHODS--Platelet rich (PRP) and platelet poor plasma (PFP) from patients with alcoholic cirrhosis, primary biliary cirrhosis, hepatic malignancy, or paracetamol overdose, or who were undergoing partial hepatectomy or liver transplantation, were assayed for t-PA, PAI-1, t-PA-PAI-1 complex and PAI-2 antigen values using specific enzyme linked immunosorbent assays (ELISAs) developed in this laboratory. RESULTS--Appreciable increases in the plasma concentration of t-PA, PAI-1, and t-PA-PAI-1 were seen in patients with alcoholic cirrhosis, primary biliary cirrhosis, and hepatic malignancy. Liver damage due to paracetamol overdose and partial hepatectomy both resulted in a striking increase in plasma PAI-1 concentration, although concentrations of t-PA and t-PA-PAI-1 complex were less affected. Concentrations of t-PA, PAI-1, and t-PA-PAI-1 complex returned to near normal values after successful liver transplantation in a patient with chronic active hepatitis. PAI-2 was also detected in several patients with chronic liver disorders. CONCLUSIONS--Haemorrhage due to fibrinolytic bleeding is commonly associated with liver disease. The patients studied here all had appreciable increases in circulating t-PA antigen concentrations. This was associated with increased concentrations of PAI-1 antigen and t-PA-PAI-1 complex and the balance between activator and inhibitor did not result in systemic plasmin generation. Reduced PAI-1 activity in cirrhosis or a critical difference in the ratio of t-PA to PAI-1 concentrations may explain the enhanced plasminogen activator activity previously noted in cirrhosis but not metastatic disease. Reduced hepatic clearance of t-PA and t-PA-PAI-1 complex due to impaired liver function may account for increased concentrations of free and complexed t-PA.     

Decreased plasma fibrin degradation products during hormonal stimulation for in vitro fertilisation

In vitro fertilisation with embryo transfer (IVFET) is associated with an increased risk of venous thrombosis. In order to determine to which extent the hormonal preparation required for IVFET could be involved in this complication, we have measured major plasma fibrinolytic components in 13 women before and during the ovarian stimulation. After pituitary desensitization with buserelin, plasma levels of fibrin degradation products (FbDP) and fibrinogen were significantly decreased. Tissue-type plasminogen activator antigen (t-PA), plasminogen activator inhibitor 1 antigen (PAI-1), FbDP and fibrinopeptide A remained unchanged. After a subsequent stimulation by human menopausal gonadotropins, FbDP plasma levels remained low, while fibrinogen returned to normal levels. t-PA antigen and PAI-1 antigen plasma levels decreased and were correlated with increased serum estradiol levels. Therefore, estradiol could be involved in the regulation of the fibrinolytic balance to some extent; during IVFET hormonal preparation, a decreased plasma fibrinolytic capacity can be questioned, thus favouring the appearance of a thrombotic event.     

不同剂量阿托伐他汀对急性冠脉综合征患者体内炎症反应、血小板活性及纤溶活性的影响

目的观察不同剂量阿托伐他汀对急性冠脉综合征(ACS)患者外周血中总胆固醇(TC)、高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血栓素B2(TXB2)、血小板颗粒膜蛋白-140(GMP-140)、血浆纤溶酶原激活剂抑制物-1(PAI-1)水平及血浆组织型纤溶酶原激活剂(t-PA)活性的影响。探讨阿托伐他汀对ACS防治的可能机制及不同剂量阿托伐他汀的安全性。方法ACS患者65例,在拜阿斯匹林、氯吡格雷等基础治疗外随机分为三组,分别给予阿托伐他汀10mg/d、20mg/d、40mg/d睡前服用。入院第1天、第14天分别抽取空腹静脉血16ml。测定hs-CRP、IL-6、TXB2、GMP-140、t-PA、PAI-1及TC、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)。采用SPSS13.0统计软件对检测结果的组间及治疗前后进行比较。结果三组TC、hs-CRP、IL-6、TXB2、GMP-140、PAI-1治疗后均有下降、t-PA活性上升,治疗后三组间比较亦有差异;而三组治疗前后CK、ALT、AST组间无显著差异,治疗后无显著上升,以上结果均有统计学意义。结论阿托伐他汀对ACS患者血脂及炎症反应、血小板活性、纤溶活性有积极作用,并在一定范围内随着剂量的增加而加强,同时具有良好的安全性。     

Fibrinolytic changes during acute vascular damage induced by Mediterranean spotted fever

Hemostatic abnormalities and microvascular injury have been described in patients with Mediterranean spotted fever (MSF). Rickettsial vasculitis comprises endothelial injury and the immune and phagocytic host response. Only indirect evidence of activation of the fibrinolytic system has been reported in MSF, but no data on plasma levels of their main components, tissue type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1), in this disease are available. To obtain quantitative information on the ‘in vivo’ activation of the fibrinolytic system during the acute and subacute phase of the endothelial damage, several fibrinolytic components were studied in 28 MSF patients. Upon admission (day 1), patients showed a significant increase both in t-PA (30±20 ng/ml) and in PAI-1 antigen levels (55±30 ng/ml) as compared with normal levels (9±4 ng/ml and 11±4 ng/ml, respectively). The levels of PAI-1 activity were also increased (median: 7U/ml, range: 0–24 U/ml), but not significantly (normal values, median: 3 U/ml, range: 0.5–5 U/ml). After remission of the disease (day 30) a significant decrease in t-PA and PAI-1 antigen levels was observed in comparison with day 1, but the PAI-1 antigen concentration remained increased in comparison with normal values. The decrease in the ratio VIII:C/vWF:Ag found in the acute phase of the disease and after 30 days could indicate that the endothelial damage remains after this period. Tissue necrosis factor α (TNFα), a potential modulator of fibrinolytic system during gram-negative sepsis, showed normal values during the acute phase of the disease and at day 30. The data found in this study indicate that the changes observed in the fibrinolytic system during MSF could be due to the endothelial damage found in the acute phase of the disease. The increased plasma PAI-1 levels could contribute to an increase in the risk of venous thrombosis in MSF patients.     

Induction of t-PA Synthesis with intravenous bolus injection of vitamin A palmitate in vitamin a deficient rats

Retinoic acid and vitamin A palmitate induce tissue-type plasminogen activator (t-PA) synthesis in cultured human umbilical vein endothelial cells (HUVEC) in vitro without alteration of plasminogen activator inhibitor-] (PAI-1) synthesis. Therefore the effect of intravenous bolus injection of water-miscible vitamin A palmitate on the blood fibrinolytic system was investigated in normal and vitamin A deficient rats. In 5 normal rats, injection of 200000 IU/kg of vitamin A palmitate did not induce a significant increase in euglobulin fibrinolytic activity, t-PA antigen and PAI activity in plasma nor of t-PA and PAI-1 mRNA in the heart within 240 min after injection. In groups of 3–6 vitamin A deficient rats, injection of 200000IU/kg of vitamin A palmitate induced a significant increase in t-PA antigen in plasma (1.9-fold after 60 min and 2.9-fold after 120 min), but no significant increase in plasma euglobulin fibrinolytic activity. A 2-fold increase in PAI activity was observed 90 min after injection of both vitamin A palmitate as well as of its solvent, suggesting that this induction was non-specific. The increase in t-PA antigen coincided with a significant increase in t-PA mRNA in heart tissue: 2.3-fold after 60 min and 4.3-fold after 120 min. PAI-1 mRNA in heart tissue increased 3.6-fold 90 min after injection with vitamin A palmitate but, surprisingly, not after injection of solvent.It is concluded that intravenous bolus injection of vitamin A palmitate induces a specific increase of t-PA mRNA in the heart and of t-PA antigen secretion in plasma of vitamin A deficient rats.     

Human gender differences in fibrinolytic responses to exercise training and their determinants

Endurance exercise training improves fibrinolysis, but this training-induced adaptation may differ somewhat between men and women. We sought to determine whether the potential gender differences in training-induced changes in selected fibrinolysis measures were related to changes in adiposity and/or plasma lipoprotein lipid levels. Seventeen men and 28 women, 50-75 years old, who were generally overweight to obese, were assessed for plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator (t-PA) activity, t-PA antigen and plasma lipoprotein-lipid levels, and body composition before and after 6 months of endurance exercise training while on a low-fat diet. At baseline, there were no differences in fibrinolytic measures between the men and women. Baseline levels of these fibrinolytic markers in both men and women were primarily related to other fibrinolytic measures and body composition, with a smaller contribution from plasma high-density lipoprotein cholesterol (HDL-C) levels. Exercise training reduced t-PA antigen levels in both men and women, but the reduction was significantly greater in men (-1.6 +/- 0.3 versus -0.5 +/- 0.2 ng ml(-1), P = 0.007). Exercise training decreased PAI-1 activity more in men than in women (-2.6 +/- 1.4 versus +0.9 +/- 0.9 IU ml(-1), P = 0.03). Men and women both showed increased t-PA activity with exercise training to the same extent (+0.38 +/- 0.12 versus +0.36 +/- 0.24 U ml(-1)). The changes in fibrinolytic measures with exercise training in men and women were correlated with changes in other fibrinolytic measures, although in men abdominal fat changes were a strong predictor of fibrinolytic changes with training. These findings suggest that training-induced improvements in endogenous fibrinolysis markers are somewhat greater in men compared to women and may be more strongly associated with abdominal obesity in men.     

代谢综合征患者纤溶活性与胰岛素抵抗的关系

目的:探讨代谢综合征患者血浆纤溶活性及与胰岛素抵抗的关系。方法:选择单纯代谢综合征患者36例,代谢综合征合并冠心病患者44例和健康人群对照20例。观察一般情况,并测定血浆纤溶酶原激活抑制物-1(PAI-1)和组织型纤溶酶原激活物(t-PA)、纤维蛋白原(Fib)、空腹血糖(FBG)、空腹血胰岛素(Ins)和血脂等指标;计算胰岛素敏感指数(ISI)。结果:代谢综合征患者的ISI较正常对照组明显下降(P<0.05);血浆PAI-1、Fib等明显升高(P<0.05)。代谢综合征合并冠心病组PAI-1与Fib、Ins正相关,与ISI、高密度脂蛋白(HDL)负相关。结论:代谢综合征患者存在明显的胰岛素抵抗和纤溶活性异常,同时纤溶活性异常与胰岛素抵抗相关。     

Levels of tissue-type plasminogen activator and plasminogen activator inhibitor 1 in disseminated intravascular coagulation syndrome

Since disseminated intravascular coagulation (DIC) may directly reflect the abnormal regulation of the fibrinolytic system by endothelial cells, we have measured the levels of tissue-type plasminogen activator (t-PA), type 1 PA inhibitor (PAI-1) and t-PA . PAI-1 complex which is formed as a result of interaction on the two factors, in the plasma of patients with DIC (n = 51) and healthy controls (n = 42). Antigens of t-PA, PAI-1 and t-PA . PAI-1 complex were significantly increased in the DIC plasma (36.4 +/- 25.1, 106.8 +/- 54.7 and 46.6 +/- 34.5 ng/ml, respectively) compared with those in normal plasma (8.5 +/- 4.3, 54.4 +/- 21.2 and 8.6 +/- 3.5 ng/ml, respectively). The molar ratio of t-PA to PAI-1 was much higher in the DIC plasma (1:3) than in normal plasma (1:6), which caused enhancement of the whole fibrinolytic activity in the DIC plasma. These changes resulted in significant consumption of plasminogen, alpha 2-plasmin inhibitor (alpha 2-PI) and a significant increase of plasmin . alpha 2-PI complex (PPI) and D-dimer. These results suggest that t-PA and its specific inhibitor PAI-1 both of which are secreted from endothelial cells into blood, play an important role on the progress of DIC.