Urano Tetsumei, Suzuki Yuko
Department of Physiology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
Rinsho Byori. 2011 Jul;59(7):703-8.
To accurately assess fibrinolytic activity in plasma, many different assay methods are employed. We divided these to three categories by their capabilities. The method to assay plasminogen activation potential is the first, which is essentially determined by the balance between tissue plasminogen activator (tPA) and plasminogen activator inhibitor type 1(PA-1), and could be evaluated by plasma levels of these molecules as well as euglobulin clot lysis time (ECLT). The method to assay plasmin-dependent fibrin degradation potential is the second, which is mainly influenced by thrombin activatable fibrinolysis inhibitor (TAFI) and alpha2-antiplasmin, and could be evaluated by plasma levels of these modifiers as well as tPA supplemented plasma clot lysis time. The method to estimate ongoing status of fibrinolytic reaction in-vivo is the last, which could be evaluated by plasma levels of FDP including D-dimer and alpha2-antiplasmin-plasmin complex. Employing the methods in the first two categories, we may estimate the risk for thrombosis. Employing the methods in the last two categories, we may estimate the effectiveness as well as the bleeding risk of thrombolytic therapy. These assay methods are described together with underlying molecular mechanisms at each step of fibrinolytic system.
为准确评估血浆中的纤溶活性，人们采用了许多不同的检测方法。我们根据其功能将这些方法分为三类。第一类是检测纤溶酶原激活潜能的方法，它主要由组织纤溶酶原激活物（tPA）和纤溶酶原激活物抑制剂1型（PA - 1）之间的平衡决定，可通过这些分子的血浆水平以及优球蛋白凝块溶解时间（ECLT）进行评估。第二类是检测纤溶酶依赖性纤维蛋白降解潜能的方法，它主要受凝血酶激活的纤溶抑制物（TAFI）和α2 - 抗纤溶酶影响，可通过这些调节剂的血浆水平以及补充tPA的血浆凝块溶解时间进行评估。最后一类是评估体内纤溶反应进行状态的方法，可通过包括D - 二聚体的纤维蛋白降解产物（FDP）和α2 - 抗纤溶酶 - 纤溶酶复合物的血浆水平进行评估。采用前两类方法，我们可以估计血栓形成的风险。采用后两类方法，我们可以评估溶栓治疗的有效性和出血风险。这些检测方法将与纤溶系统每个步骤的潜在分子机制一起进行描述。
