Awada H, Barlowatz-Meimon G, Dougados M, Maisonneuve P, Sultan Y, Amor B
Clinique de Rhumatologie, Hôpital Cochin, Paris, France.
J Lab Clin Med. 1988 Feb;111(2):229-36.
Fibrinolysis was evaluated in 16 women with SLE, who were divided into three groups of increasing disease severity according to their past history, and in 10 normal subjects. Fibrinolysis parameters assessed were tissue-type plasminogen activator (t-PA) activity in plasma and in euglobulin fractions and rapid plasminogen activator inhibitor activity. All parameters were evaluated before and after venous occlusion to assess endothelial cell t-PA release in response to localized anoxia. Markers of deficient fibrinolysis were persistently undetectable t-PA activity and increased rapid plasminogen activator inhibitor activity after venous occlusion. Defective fibrinolysis was correlated with disease severity; it was noted only in patients with severe or moderate disease and in no patients with mild disease or in controls. Fibrinolysis abnormalities were independent of disease activity, suggesting that vascular endothelium injuries occurring during flare-ups persist during inactive phases of the disease. No correlation was found between fibrinolysis abnormalities and disease duration, corticosteroid administration, or the presence of lupus anticoagulant or anticardiolipin antibodies. These data support the hypothesis of parallelism between the severity of vascular injuries, suggested by deficient fibrinolysis, and the severity of clinical manifestations in SLE.
对16名系统性红斑狼疮（SLE）女性患者进行了纤维蛋白溶解评估，根据她们的既往病史将其分为三组，疾病严重程度逐渐增加，同时评估了10名正常受试者。评估的纤维蛋白溶解参数包括血浆和优球蛋白组分中的组织型纤溶酶原激活物（t-PA）活性以及快速纤溶酶原激活物抑制剂活性。在静脉阻塞前后评估所有参数，以评估内皮细胞对局部缺氧的反应中t-PA的释放情况。纤维蛋白溶解不足的标志物是静脉阻塞后t-PA活性持续检测不到且快速纤溶酶原激活物抑制剂活性增加。纤维蛋白溶解缺陷与疾病严重程度相关；仅在重度或中度疾病患者中观察到，轻度疾病患者或对照组中未观察到。纤维蛋白溶解异常与疾病活动无关，这表明疾病发作期间发生的血管内皮损伤在疾病非活动期持续存在。未发现纤维蛋白溶解异常与疾病持续时间、皮质类固醇给药或狼疮抗凝物或抗心磷脂抗体的存在之间存在相关性。这些数据支持了由纤维蛋白溶解不足提示的血管损伤严重程度与SLE临床表现严重程度之间平行关系的假设。
