Department of Neurology, Yonsei University Wonju College of Medicine, Korea.
J Clin Neurol. 2005 Oct;1(2):142-7. doi: 10.3988/jcn.2005.1.2.142. Epub 2005 Oct 20.
Thrombolytics-induced recanalization fails in a significant portion of patients with ischemic stroke, which is partly due to the resistance of clots to lysis by thrombolytic agents. The pretreatment level of endogenous fibrinolysis inhibitors may affect such thrombolysis failure.
We studied 43 stroke patients whose arterial recanalization had been evaluated by angiography, and whose blood had been obtained prior to the administration of thrombolytic agents. Plasma samples from 34 healthy volunteers were used as normal controls. Plasminogen activator inhibitor type 1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor (TAFI) levels were quantified using an enzyme-linked immunosorbent assay.
Arteries were recanalized [Thrombolysis in Myocardial Infarction (TIMI) grade 2 or 3] in 30 patients, but not (TIMI grade 0 or 1) in the other 13. The plasma PAI-1 level was significantly higher in patients without recanalization (nonrecanalization) than in those with recanalization and in normal controls. The TAFI levels did not differ among the groups.
The pretreatment PAI-1 levels are increased in acute stroke patients with thrombolysis failure.
溶栓治疗未能使相当一部分缺血性脑卒中患者的血管再通,部分原因是血栓对溶栓药物的抵抗。内源性纤维蛋白溶解抑制剂的预处理水平可能会影响溶栓失败。
我们研究了 43 例接受血管造影评估动脉再通的脑卒中患者,这些患者在使用溶栓药物之前采集了血液样本。34 名健康志愿者的血浆样本作为正常对照。采用酶联免疫吸附试验定量检测纤溶酶原激活物抑制剂 1(PAI-1)和凝血酶激活的纤维蛋白溶解抑制剂(TAFI)水平。
30 例患者的动脉再通(血栓溶解治疗心肌梗死 [TIMI] 2 级或 3 级),而其余 13 例患者未再通(TIMI 0 级或 1 级)。无再通患者(非再通组)的血浆 PAI-1 水平明显高于再通组和正常对照组。各组 TAFI 水平无差异。
溶栓治疗失败的急性脑卒中患者的预处理 PAI-1 水平升高。