Hysell D C, Smith M R, Brewster P S, Fraker T D
Department of Medicine, Medical College of Ohio, Toledo 43699.
Am J Clin Pathol. 1988 Aug;90(2):200-5. doi: 10.1093/ajcp/90.2.200.
The fluorogenic synthetic substrate and radial immunodiffusion assays of plasma plasminogen were compared before and after administration of intravenous streptokinase in differing doses to 57 patients being treated for acute myocardial infarction. There was a moderate correlation (r = 0.73, slope = 0.221, intercept = 1.005, n = 57 pairs) in the two assays of plasma plasminogen before the administration of streptokinase. After streptokinase, however, the correlation of the two assays was poor (r = 0.28, slope = 0.03, y-intercept = 0.003, n = 57 pairs). The decrease in plasma plasminogen by the fluorogenic synthetic substrate assay after streptokinase averaged 95 +/- 5%, with little variation between doses. In contrast, the percentage decrease in plasma plasminogen after streptokinase by the radial immunodiffusion assay averaged only 30 +/- 11%. The percentage change in plasma plasminogen by the two assays is significantly different (P = 0.001). The discrepancy in the percentage change in plasma plasminogen after streptokinase as measured by the fluorogenic synthetic substrate assay and the radial immunodiffusion assay can be explained by a lack of specificity for the antibody to plasminogen in the radial immunodiffusion kit. Antigen-antibody precipitin rings were observed after incubation of antibody with a mixture presumed to contain plasmin, plasmin-alpha 2 antiplasmin complexes, and plasmin-fibrin/fibrinogen degradation products. Based on these data, the fluorogenic synthetic substrate assay for plasma plasminogen is a superior means of following plasminogen depletion in response to thrombolytic therapy after streptokinase treatment for acute myocardial infarction.
对57例接受急性心肌梗死治疗的患者静脉注射不同剂量链激酶前后，比较了血浆纤溶酶原的荧光合成底物法和单向免疫扩散法。在注射链激酶前，两种血浆纤溶酶原检测方法具有中等相关性（r = 0.73，斜率 = 0.221，截距 = 1.005，n = 57对）。然而，注射链激酶后，两种检测方法的相关性较差（r = 0.28，斜率 = 0.03，y截距 = 0.003，n = 57对）。荧光合成底物法检测显示，注射链激酶后血浆纤溶酶原平均下降95±5%，不同剂量间变化不大。相比之下，单向免疫扩散法检测显示，注射链激酶后血浆纤溶酶原平均下降仅30±11%。两种检测方法测得的血浆纤溶酶原百分比变化差异有统计学意义（P = 0.001）。荧光合成底物法和单向免疫扩散法检测注射链激酶后血浆纤溶酶原百分比变化的差异，可解释为单向免疫扩散试剂盒中抗纤溶酶原抗体缺乏特异性。用假定含有纤溶酶、纤溶酶-α2抗纤溶酶复合物和纤溶酶-纤维蛋白/纤维蛋白原降解产物的混合物与抗体孵育后，观察到抗原-抗体沉淀环。基于这些数据，荧光合成底物法检测血浆纤溶酶原是急性心肌梗死患者接受链激酶溶栓治疗后监测纤溶酶原消耗的较好方法。
