Levin R I, Harpel P C, Harpel J G, Recht P A
Division of Cardiology, New York University School of Medicine, NY.
Blood. 1989 Oct;74(5):1635-43.
The observation that aspirin inhibits the increment in tissue plasminogen activator (t-PA) activity induced by venous occlusion of the forearm became controversial with the publication of several nonconfirmatory studies. The current study was performed to confirm the original observation and determine the mechanism by which aspirin suppresses the incremental t-PA activity induced by venous occlusion. Aspirin (650 mg/d X 2) caused no change in resting levels of t-PA antigen (t-PA:Ag) or activity, plasminogen activator inhibitor 1 antigen (PAI-1:Ag), or activity or t-PA-PAI-1 complexes. In contrast, aspirin reduced the increments induced by venous occlusion as follows: t-PA:Ag by 45% (P = .001); t-PA activity (euglobulin lysis time, ELT) by 43% (P = .006); and t-PA activity (alpha 2-plasmin inhibitor-plasmin complexes, PIPC) by 41% (P = .003). The inhibition of incremental t-PA activity measured as ELT or PIPC was linearly correlated with the inhibition of incremental t-PA:Ag (respectively, r = .75, P less than .02; r = .67, P less than .05). Aspirin had no effect on the increment in PAI-1:Ag induced by venous occlusion, but similar to the effect on t-PA:Ag, aspirin induced a 51% inhibition of the increment in t-PA-PAI-1 complex formation. Aspirin did not alter the ability of alpha 2-plasmin inhibitor to bind plasmin, nor the ability of plasma to support the fibrin-catalyzed generation of plasmin by t-PA, nor the subsequent formation of PIPC. Aspirin inhibits the t-PA activity induced by venous occlusion primarily by inhibiting the release of t-PA antigen.
阿司匹林抑制前臂静脉闭塞诱导的组织型纤溶酶原激活物(t-PA)活性增加这一观察结果,随着几项非证实性研究的发表而引发了争议。进行本研究以证实最初的观察结果,并确定阿司匹林抑制静脉闭塞诱导的t-PA活性增加的机制。阿司匹林(650mg/d×2)对t-PA抗原(t-PA:Ag)或活性、纤溶酶原激活物抑制剂1抗原(PAI-1:Ag)或活性以及t-PA-PAI-1复合物的静息水平无影响。相比之下,阿司匹林如下降低了静脉闭塞诱导的增加:t-PA:Ag降低45%(P = 0.001);t-PA活性(优球蛋白溶解时间,ELT)降低43%(P = 0.006);t-PA活性(α2-纤溶酶抑制剂-纤溶酶复合物,PIPC)降低41%(P = 0.003)。以ELT或PIPC测量的t-PA活性增加的抑制与t-PA:Ag增加的抑制呈线性相关(分别为r = 0.75,P<0.02;r = 0.67,P<0.05)。阿司匹林对静脉闭塞诱导的PAI-1:Ag增加无影响,但与对t-PA:Ag的作用类似,阿司匹林对t-PA-PAI-1复合物形成增加诱导了51%的抑制。阿司匹林不改变α2-纤溶酶抑制剂结合纤溶酶的能力,也不改变血浆支持t-PA催化纤维蛋白生成纤溶酶的能力,以及随后PIPC的形成。阿司匹林主要通过抑制t-PA抗原的释放来抑制静脉闭塞诱导的t-PA活性。