Takahashi H, Ito S, Hanano M, Wada K, Niwano H, Seki Y, Shibata A
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Am J Hematol. 1992 Sep;41(1):32-9. doi: 10.1002/ajh.2830410107.
Circulating thrombomodulin is a novel endothelial cell marker, which may reflect the endothelial injury. Plasma levels of thrombomodulin were quantitated by an enzyme-linked immunosorbent assay (ELISA) in patients with hematological malignancies, liver disease, diabetes mellitus, collagen disease, thrombotic disease, and disseminated intravascular coagulation (DIC), and the thrombomodulin values were compared with those of von Willebrand factor antigen (vWf:Ag) and tissue-type plasminogen activator (t-PA) which are released from stimulated or damaged endothelial cells. The mean plasma concentrations of thrombomodulin in these disease states were elevated as compared with healthy subjects. A relatively high mean thrombomodulin level was observed in DIC, liver disease, and collagen disease. Abnormally high thrombomodulin values (greater than normal mean value + 3 SD) were found in 32.3% of patients with hematological malignancies, 57.7% of patients with liver disease, 39.3% of patients with diabetes mellitus, 30.0% of patients with collagen disease, 23.1% of patients with thrombotic disease, and 69.0% of patients with DIC. Plasma concentrations of both vWf:Ag and t-PA were also elevated in these patients. On the whole, the plasma thrombomodulin concentration was positively correlated with vWf:Ag (r = 0.441, P less than 0.001) and t-PA (r = 0.398, P less than 0.001). These findings indicate that the elevation of plasma thrombomodulin is frequently seen in a variety of diseases and circulating thrombomodulin is possibly useful for evaluating the endothelial damage in selected disease states.
循环血栓调节蛋白是一种新型内皮细胞标志物，可能反映内皮损伤。采用酶联免疫吸附测定法（ELISA）对血液系统恶性肿瘤、肝病、糖尿病、胶原病、血栓性疾病及弥散性血管内凝血（DIC）患者的血浆血栓调节蛋白水平进行定量，并将血栓调节蛋白值与从受刺激或受损内皮细胞释放的血管性血友病因子抗原（vWf:Ag）和组织型纤溶酶原激活剂（t-PA）的值进行比较。与健康受试者相比，这些疾病状态下血浆血栓调节蛋白的平均浓度升高。在DIC、肝病和胶原病中观察到相对较高的平均血栓调节蛋白水平。血液系统恶性肿瘤患者中有32.3%、肝病患者中有57.7%、糖尿病患者中有39.3%、胶原病患者中有30.0%、血栓性疾病患者中有23.1%以及DIC患者中有69.0%的血栓调节蛋白值异常升高（高于正常平均值+3标准差）。这些患者的vWf:Ag和t-PA血浆浓度也升高。总体而言，血浆血栓调节蛋白浓度与vWf:Ag（r = 0.441，P<0.001）和t-PA（r = 0.398，P<0.001）呈正相关。这些发现表明，血浆血栓调节蛋白升高在多种疾病中常见，循环血栓调节蛋白可能有助于评估特定疾病状态下的内皮损伤。
