Ambrus J L, Ambrus C M
Roswell Park Memorial Institute, Buffalo, NY 14263.
J Med. 1990;21(1-2):67-84.
Five hundred premature infants were treated on a randomized double-blind basis with human plasminogen or placebo. We found that in premature infants plasminogen levels are low; thus, defense against intra-alveolar fibrin deposition during birth trauma is reduced. A significant decrease in the incidence of respiratory distress syndrome-hyaline membrane disease and death was seen in the treated infants. Infants with established respiratory distress syndrome were treated with human plasmin or placebo. A significant decrease in death rate was found in the treated infants. Decreased plasminogen and anti-thrombin III (AT-III) levels were found in patients with adult respiratory distress syndrome and/or septic shock. These levels returned to normal within 14 days in survivors, but remained depressed in those who died. It was thought that these parameters may have diagnostic and predictive values. In experimental animals, injection of E. coli endotoxin or oleic acid produced an adult respiratory distress syndrome type phenomenon. This was also accompanied by decreases in plasminogen levels, with recovery in the survivors. It is suggested that plasminogen and anti-thrombin III should be explored as auxiliary therapeutic agents in adult respiratory distress syndrome.
500名早产儿被随机分为两组，分别接受人纤溶酶原或安慰剂的双盲治疗。我们发现，早产儿的纤溶酶原水平较低，因此在出生创伤期间抵御肺泡内纤维蛋白沉积的能力下降。接受治疗的婴儿中，呼吸窘迫综合征-透明膜病的发病率和死亡率显著降低。已确诊为呼吸窘迫综合征的婴儿接受人纤溶酶或安慰剂治疗。接受治疗的婴儿死亡率显著降低。在成人呼吸窘迫综合征和/或脓毒性休克患者中发现纤溶酶原和抗凝血酶III（AT-III）水平降低。幸存者的这些水平在14天内恢复正常，但死亡者的水平仍处于较低状态。据认为，这些参数可能具有诊断和预测价值。在实验动物中，注射大肠杆菌内毒素或油酸会产生类似成人呼吸窘迫综合征的现象。这也伴随着纤溶酶原水平的降低，幸存者的纤溶酶原水平会恢复。建议将纤溶酶原和抗凝血酶III作为成人呼吸窘迫综合征的辅助治疗药物进行研究。
