Drouet L, Baudin B, Baumann F C, Caen J P
Département d'Angio-Hématologie, INSERM U 150, CNRS UA 334, Hôpital Lariboisière, Paris, France.
J Lab Clin Med. 1988 Oct;112(4):450-7.
Aa a plasma marker of an endothelial abnormality, the serum activity of angiotensin-converting enzyme (ACE) was investigated at rest and after stimulation either by local venostasis or infusion of an analogue of lysine-vasopressin (desmopressin acetate). Desmopressin acetate did not induce any significant change in ACE, in contrast to the effect of venostasis. Searching for an endothelial abnormality implicated in the genesis of deep vein thrombosis, we used the local venostasis test in patients affected by recurrent deep vein thrombosis. Patients, divided in three groups (group I, documented history of recurrent deep vein thrombosis; group II, only one deep vein thrombosis or recurrent superficial venous thrombosis; group III, history of arterial thromboembolism), and controls were screened for basal and stimulated levels of serum ACE, together with fibrinolytic activity and von Willebrand factor level. Two types of abnormalities of serum ACE activity were found: low basal level in group I, and low response to venostasis in groups I and III; group II did not differ from controls. Measures of fibrinolytic and ACE activities are not redundant because the two types of ACE abnormalities were not individually encountered in the same patients and were independent from abnormalities of the fibrinolytic system. These findings suggest that an endothelial lesion could participate in the pathogenesis of some forms of recurrent deep vein thrombosis and support interest in the measurement of serum ACE to discriminate some patients at high risk of deep vein thrombosis.
作为内皮异常的血浆标志物，我们研究了血管紧张素转换酶（ACE）在静息状态下以及在局部静脉淤滞或输注赖氨酸加压素类似物（醋酸去氨加压素）刺激后的血清活性。与静脉淤滞的作用相反，醋酸去氨加压素未引起ACE的任何显著变化。为了寻找与深静脉血栓形成有关的内皮异常，我们对患有复发性深静脉血栓形成的患者进行了局部静脉淤滞试验。将患者分为三组（第一组，有复发性深静脉血栓形成的记录病史；第二组，仅有一次深静脉血栓形成或复发性浅静脉血栓形成；第三组，有动脉血栓栓塞病史），并对对照组以及患者进行血清ACE基础水平和刺激后水平、纤溶活性和血管性血友病因子水平的筛查。发现了两种血清ACE活性异常类型：第一组基础水平低，第一组和第三组对静脉淤滞的反应低；第二组与对照组无差异。纤溶活性和ACE活性的检测并非多余，因为这两种ACE异常类型并未在同一患者中单独出现，且与纤溶系统异常无关。这些发现表明，内皮病变可能参与某些形式的复发性深静脉血栓形成的发病机制，并支持对血清ACE检测的关注，以鉴别一些深静脉血栓形成高危患者。
