Francis C W, Markham R E, Marder V J
Blood. 1984 May;63(5):1216-24.
Fibrin prepared from 15 pathologic thrombi was examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to determine the extent and pattern of fibrinolysis that occurs in vivo. Two groups of patients could be distinguished on the basis of the polypeptide chain composition of fibrin in their thrombi. Those patients who presented with acute vascular obstruction, either arterial or venous, showed a minimal degree of fibrin degradation, with a dominance of intact, undegraded crosslinked gamma-gamma dimers. On the other hand, patients with long-standing symptoms associated with chronic aortic aneurysms had thrombi containing extensively degraded fibrin. Thrombi in large aortic aneurysms were dissected into concentric layers that showed different degrees of fibrinolysis. The luminal surface consisted of fresh, red thrombus and contained undegraded crosslinked fibrin similar to that found in patients with acute occlusive disease. Deeper layers of the thrombus showed gamma-gamma chain degradation throughout, indicating that this portion was undergoing active thrombolysis. The findings demonstrate that the variability in the pathophysiologic balance between coagulation and fibrinolysis is reflected in vivo by the polypeptide chain composition of crosslinked fibrin in thrombi. The results support the hypothesis of a dynamic equilibrium between clotting and lysis, but indicate that the balance between these two processes may be distinctly different in separate areas of a single clot.
对从15个病理性血栓中制备的纤维蛋白进行十二烷基硫酸钠-聚丙烯酰胺凝胶电泳，以确定体内发生的纤维蛋白溶解程度和模式。根据血栓中纤维蛋白的多肽链组成，可以区分出两组患者。那些出现急性血管阻塞（无论是动脉还是静脉）的患者，其纤维蛋白降解程度最小，以完整、未降解的交联γ-γ二聚体为主。另一方面，患有与慢性主动脉瘤相关的长期症状的患者，其血栓中含有大量降解的纤维蛋白。大主动脉瘤中的血栓被切成同心层，显示出不同程度的纤维蛋白溶解。管腔表面由新鲜的红色血栓组成，含有与急性闭塞性疾病患者中发现的类似的未降解交联纤维蛋白。血栓的更深层显示γ-γ链全程降解，表明该部分正在进行活跃的血栓溶解。这些发现表明，凝血和纤维蛋白溶解之间病理生理平衡的变异性在体内通过血栓中交联纤维蛋白的多肽链组成得以体现。结果支持凝血和溶解之间动态平衡的假说，但表明这两个过程之间的平衡在单个血栓的不同区域可能明显不同。
