Antovic Jovan P, Yngen Marianne, Ostenson Claes-Göran G, Antovic Aleksandra, Wallen Håkan N, Jorneskög Gun, Blombäck Margareta
Department of Surgical Sciences, Karolinska Institutet, Karolinska Institutet, Stockholm, Sweden. Jovan.
Blood Coagul Fibrinolysis. 2003 Sep;14(6):551-6. doi: 10.1097/00001721-200309000-00006.
We investigated thrombin activatable fibrinolysis inhibitor (TAFI) and its influence on fibrinolysis by measuring pro-TAFI activity and total TAFI antigen in 38 patients with type I diabetes mellitus (18 with and 20 without microvascular complications), as well as in 20 healthy controls. The pro-TAFI levels in the two groups of patients did not differ from those in the control group. Total TAFI antigen [i.e. pro-TAFI, TAFI and inactive carboxypeptidase U (TAFIi)] tended to decrease in both the patient groups (59.7 +/- 7.2 and 73.4 +/- 8.9% with and without microvascular complications, respectively) compared with controls (91.9 +/- 12.2%) (P = 0.12). We also assessed the overall hemostatic potential (OHP) in plasma, the clot lysis time and the overall fibrinolytic potential. The OHP was significantly higher in patients with complications compared with controls (8.9 +/- 0.9 versus 6.7 +/- 0.4; P < 0.05) and also higher in the diabetics without complications (7.8 +/- 0.6), although the latter difference did not reach statistical significance. Levels of clot lysis time and overall fibrinolytic potential were similar in the two groups of patients and the controls. The increased OHP in plasma from diabetic patients with microvascular complications indicates an imbalance of the hemostatic system towards a prothrombotic state. No signs of impaired fibrinolysis were observed in patients with diabetes. Using the OHP method for estimation of overall hemostasis, it seems that TAFI does not influence either fibrinolysis or the increased thrombotic potential observed in patients with type I diabetes mellitus.
我们通过检测38例I型糖尿病患者（18例有微血管并发症，20例无微血管并发症）以及20例健康对照者的凝血酶激活的纤溶抑制物（TAFI）前体活性和总TAFI抗原，研究了TAFI及其对纤溶的影响。两组患者的TAFI前体水平与对照组无差异。与对照组（91.9±12.2%）相比，两组患者的总TAFI抗原[即TAFI前体、TAFI和无活性羧肽酶U（TAFIi）]均有下降趋势（有微血管并发症和无微血管并发症的患者分别为59.7±7.2%和73.4±8.9%）（P = 0.12）。我们还评估了血浆中的整体止血潜力（OHP）、凝血块溶解时间和整体纤溶潜力。有并发症的患者的OHP显著高于对照组（8.9±0.9对6.7±0.4；P < 0.05），无并发症的糖尿病患者的OHP也较高（7.8±0.6），尽管后一差异未达到统计学意义。两组患者和对照组的凝血块溶解时间和整体纤溶潜力水平相似。微血管并发症糖尿病患者血浆中OHP升高表明止血系统失衡，倾向于血栓形成状态。未观察到糖尿病患者有纤溶受损的迹象。使用OHP方法评估整体止血情况，似乎TAFI对I型糖尿病患者的纤溶或观察到的血栓形成潜力增加均无影响。
