Potter van Loon B J, Rijken D C, Brommer E J, van der Maas A P
Westeinde Hospital, Dept. of Internal Medicine, Den Haag, The Netherlands.
Thromb Haemost. 1992 Jan 23;67(1):101-5.
Thrombolytic therapy successfully reopens obstructed blood vessels in the majority of cases. However, it is not known why a substantial amount of thrombi are resistant to lysis by a fibrinolytic agent. In vitro studies have demonstrated that tissue-type plasminogen activator (t-PA) and plasminogen incorporated in the clot (during formation) increase lysibility. To test whether lysibility of in vivo formed human thrombi is related to their composition, we studied 25 venous thrombi obtained at autopsy and 21 arterial thrombi obtained during embolectomy. Plasminogen activator inhibitor-1 (PAI-1) antigen was measured in a phosphate-buffered saline (PBS) extract of each thrombus; t-PA antigen and plasminogen antigen were determined in a 6 M urea extract of the thrombus, representing bound proteins. Lysibility was measured as weight reduction during 8 h of incubation in PBS containing streptokinase (SK) 100 U/ml, corrected for spontaneous lysis, reflected by weight loss in PBS without SK. In addition, lysibility in SK was compared with lysibility in urokinase (UK) 100 U/ml and in t-PA 200 U/ml. Spontaneous lysis amounted to 29 +/- 5% (mean +/- SEM) and 33 +/- 5% in venous and arterial thrombi, respectively, and inversely correlated with the PAI-1 content of thrombi (r = -0.43, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
溶栓疗法在大多数情况下能成功使阻塞的血管再通。然而，尚不清楚为何大量血栓对纤溶药物的溶解具有抗性。体外研究表明，组织型纤溶酶原激活剂（t-PA）和凝块中（形成过程中）掺入的纤溶酶原可增加血栓的可溶解性。为了检测体内形成的人类血栓的可溶解性是否与其组成有关，我们研究了25例尸检获得的静脉血栓和21例栓子切除术中获得的动脉血栓。在每个血栓的磷酸盐缓冲盐水（PBS）提取物中测量纤溶酶原激活剂抑制剂-1（PAI-1）抗原；在血栓的6M尿素提取物中测定t-PA抗原和纤溶酶原抗原，代表结合蛋白。可溶解性通过在含100U/ml链激酶（SK）的PBS中孵育8小时期间的重量减轻来测量，并校正自发溶解，自发溶解通过不含SK的PBS中的重量损失来反映。此外，将SK中的可溶解性与100U/ml尿激酶（UK）和200U/ml t-PA中的可溶解性进行比较。静脉血栓和动脉血栓的自发溶解分别为29±5%（平均值±标准误）和33±5%，且与血栓的PAI-1含量呈负相关（r = -0.43，p<0.01）。（摘要截短至250字）
