Martin M
Thromb Haemost. 1976 Dec 31;36(3):566-81.
A new method is presented for estimating the activator (plasminogen-streptokinase complex) concentration in native plasma of patients undergoing streptokinase infusion. The principle of the method is based on clot lysis time as recorded by the thromboelastograph. The test clot constituents were bovine fibrinogen, bovine plasminogen, EDTA, human plasma (with unknown activator concentrations), and thrombin. In order to obtain a standardization line, urokinase dissolved in NaCl solution was substituted for patients' plasma. Thus, each lysis time could easily be converted into urokinase equivalent (CTA-u/ml). Streptokinase and plasminogen molecules in undiluted patients' plasma were found to exist both in an activator-bound (equimolar plasminogen-streptokinase complex) and in a freely circulating form. This result is in agreement with earlier findings where the activator complex was demonstrated to be a widely dissociated complex in highly diluted plasma of patients, thus displaying an ample proportion of free streptokinase and plasminogen and molecules. Streptokinase treatment using dosage schemes of 100,000 u SK/h, and 200,000 u/h were monitored by quantitative activator, streptokinase, and plasminogen measurements. An average activator concentration of 50-100 CTA-u/ml and a SK-concentration of 7-16 u/ml were recorded during streptokinase infusion. Plasminogen values averaged 0.25%, independent of the amount of streptokinase infused. Each drop in streptokinase was accompanied by a drop in activator during the infusion, and each rise in streptokinase by a rise in activator. There was a strong correlation between streptokinase and activator concentrations in that, on the average, 1 u streptokinase equalled 8.4 CTA-u/ml activator (correlation coefficient r = 0.9) It is concluded that the activator concentration in the plasma of patients undergoing fibrinolytic treatment can easily be adjusted by regulating the hourly streptokinase influx.
本文介绍了一种新方法，用于估算接受链激酶输注患者的天然血浆中激活剂（纤溶酶原 - 链激酶复合物）的浓度。该方法的原理基于血栓弹力图记录的凝块溶解时间。测试凝块成分包括牛纤维蛋白原、牛纤溶酶原、乙二胺四乙酸（EDTA）、人血浆（激活剂浓度未知）和凝血酶。为了获得标准化曲线，用溶解在氯化钠溶液中的尿激酶替代患者血浆。这样，每个溶解时间都可以轻松转换为尿激酶当量（CTA - u/ml）。发现未稀释患者血浆中的链激酶和纤溶酶原分子既以与激活剂结合的形式（等摩尔纤溶酶原 - 链激酶复合物）存在，也以自由循环形式存在。这一结果与早期研究结果一致，在早期研究中，激活剂复合物在患者高度稀释的血浆中被证明是一种广泛解离的复合物，因此显示出相当比例的游离链激酶、纤溶酶原和分子。通过定量测量激活剂、链激酶和纤溶酶原，对采用100,000 u SK/h和200,000 u/h剂量方案的链激酶治疗进行了监测。在链激酶输注期间，记录到激活剂平均浓度为50 - 100 CTA - u/ml，链激酶浓度为7 - 16 u/ml。纤溶酶原值平均为0.25%，与输注的链激酶量无关。在输注过程中，链激酶的每一次下降都伴随着激活剂的下降，链激酶的每一次上升都伴随着激活剂的上升。链激酶和激活剂浓度之间存在很强的相关性，平均而言，1 u链激酶等于8.4 CTA - u/ml激活剂（相关系数r = 0.9）。得出的结论是，通过调节每小时链激酶的输入量，可以轻松调整接受纤维蛋白溶解治疗患者血浆中的激活剂浓度。
