Jurado M, Páramo J A, Gutierrez-Pimentel M, Rocha E
Hematology Services, Hospital Virgen de las Nieves, Granada, Spain.
Thromb Haemost. 1992 Nov 10;68(5):516-20.
We studied the fibrinolytic response before and after venous occlusion (VO) in 30 patients with systemic lupus erythematosus (SLE), 25 with rheumatoid arthritis (RA) and 25 with different connective tissue disorders. Results were compared in patients with and without antiphospholipid antibodies (APA) and a history of either thrombosis or abortions. Before occlusion plasma levels of tissue-type plasminogen activator (t-PA) antigen and its inhibitor (PAI-1) were significantly higher in the patient group (p < 0.001). After occlusion, a low fibrinolytic activity on fibrin plates (p < 0.005) was observed in the same group. t-PA capacity and t-PA release were similar in relation to controls. The plasma PAI-1 activity was significantly elevated in each group of patients (p < 0.005) as compared to the control group. No significant differences with respect to t-PA and PAI-1 were observed in patients as to the presence or absence of thrombosis. There was also no correlation between the fibrinolytic changes and the presence of APA. It is concluded that an impairment of the fibrinolytic system, mainly related to increased PAI-1 levels, is present in most patients with connective tissue disorders, although these changes did not correlate with the presence of APA or the incidence of thrombosis.
我们研究了30例系统性红斑狼疮（SLE）患者、25例类风湿关节炎（RA）患者和25例患有不同结缔组织疾病的患者在静脉闭塞（VO）前后的纤溶反应。对有和没有抗磷脂抗体（APA）以及有血栓形成或流产史的患者的结果进行了比较。闭塞前，患者组血浆组织型纤溶酶原激活物（t-PA）抗原及其抑制剂（PAI-1）水平显著更高（p<0.001）。闭塞后，在同一组中观察到纤维蛋白平板上的纤溶活性较低（p<0.005）。与对照组相比，t-PA能力和t-PA释放相似。与对照组相比，每组患者的血浆PAI-1活性均显著升高（p<0.005）。在有或没有血栓形成的患者中，未观察到t-PA和PAI-1方面的显著差异。纤溶变化与APA的存在之间也没有相关性。结论是，大多数结缔组织疾病患者存在纤溶系统受损，主要与PAI-1水平升高有关，尽管这些变化与APA的存在或血栓形成的发生率无关。
