Matsuno K, Araki K
Division of Laboratory Medicine, Hokkaido University Hospital, Sapporo.
Rinsho Byori. 1991 Feb;39(2):179-84.
New trends in tests for coagulation and fibrinolysis and advances in diagnosis for the hypercoagulable state and utilization of immunological techniques such as various polyclonal and monoclonal antibodies are reported. We discussed (1) the new markers for hypercoagulable states, (2) differential diagnosis of disseminated intravascular coagulation (DIC) and abnormalities of coagulation in liver cirrhosis (LC), and (3) new markers for fibrinolysis and vascular function. Thrombin-antithrombin III complex (TAT) levels were higher in thrombotic diseases than in healthy controls. Therefore, TAT should be a good marker for hypercoagulation as fibrinopeptide A (FPA) and soluble fibrin monomer complex (SFMC). Measurement of TAT, plasma-alpha 2 plasmin inhibitor complex (PIC), and D dimer were useful for differential diagnosis of DIC and liver cirrhosis. t-PA-PAI complex correlated well with t-PA, but not with fibrinolytic parameters such as PIC. The t-PA-PAI complex may be a good marker for the function of the vascular endothelium.
本文报道了凝血和纤溶检测的新趋势、高凝状态诊断的进展以及各种多克隆和单克隆抗体等免疫技术的应用。我们讨论了:(1)高凝状态的新标志物;(2)弥散性血管内凝血(DIC)与肝硬化(LC)凝血异常的鉴别诊断;(3)纤溶和血管功能的新标志物。血栓性疾病患者的凝血酶 - 抗凝血酶III复合物(TAT)水平高于健康对照。因此,TAT应是一种与纤维蛋白肽A(FPA)和可溶性纤维蛋白单体复合物(SFMC)一样好的高凝标志物。检测TAT、血浆α2纤溶酶抑制物复合物(PIC)和D - 二聚体对DIC和肝硬化的鉴别诊断有用。组织型纤溶酶原激活物 - 纤溶酶原激活物抑制剂复合物(t - PA - PAI复合物)与t - PA相关性良好,但与PIC等纤溶参数无关。t - PA - PAI复合物可能是血管内皮功能的良好标志物。