Lai H S, Tsai T J, Chen Y M, Wu K D, Hsieh B S, Chen W Y, Yen T S
Department of Internal Medicine, Provincial Taoyuan General Hospital, Taiwan R.O.C.
J Formos Med Assoc. 1991 May;90(5):448-51.
To investigate the role plasma kallikrein plays in the in vivo activation of inactive renin, we measured plasma active renin, inactive renin, kallikrein and prekallikrein levels in 10 patients with disseminated intravascular coagulation (DIC), with 16 normal persons as controls. The plasma active renin concentration was expressed by the angiotensin I generation rate after the addition of sheep renin substrate. Plasma inactive renin was activated by trypsin. The plasma total kallikrein level was measured by an assay of kallikrein activity on synthetic substrate S-2302 after the addition of a prekallikrein activator. Plasma kallikrein was assayed by its activity on S-2302 without addition of the activator. The prekallikrein level was obtained by subtracting the kallikrein activity from the total kallikrein activity. A significant decrease in the plasma prekallikrein concentration was observed in DIC patients, as compared to that of controls (p less than 0.01). There was no significant difference in plasma levels of kallikrein, inactive renin, and the proportion of active renin between DIC patients and normal controls, but the active renin level was higher in DIC patients. There was no significant correlation between the level of plasma kallikrein and the proportion of active renin in either normal controls or DIC patients. These results are compatible with, but do not prove, the theory that plasma kallikrein plays a role in the in vivo activation of inactive renin.
为了研究血浆激肽释放酶在体内对无活性肾素激活过程中所起的作用，我们测定了10例弥散性血管内凝血（DIC）患者的血浆活性肾素、无活性肾素、激肽释放酶和前激肽释放酶水平，并以16名正常人为对照。血浆活性肾素浓度通过加入羊肾素底物后的血管紧张素I生成率来表示。血浆无活性肾素用胰蛋白酶激活。血浆总激肽释放酶水平通过加入前激肽释放酶激活剂后在合成底物S-2302上的激肽释放酶活性测定来测量。血浆激肽释放酶通过其在不添加激活剂的S-2302上的活性进行测定。前激肽释放酶水平通过从总激肽释放酶活性中减去激肽释放酶活性获得。与对照组相比，DIC患者血浆前激肽释放酶浓度显著降低（p小于0.01）。DIC患者与正常对照组之间血浆激肽释放酶、无活性肾素水平及活性肾素比例无显著差异，但DIC患者活性肾素水平较高。在正常对照组或DIC患者中，血浆激肽释放酶水平与活性肾素比例之间均无显著相关性。这些结果与血浆激肽释放酶在体内对无活性肾素激活过程中起作用的理论相符，但并未证实该理论。
