Brommer E J, Verheijen J H, Chang G T, Rijken D C
Thromb Haemost. 1984 Oct 31;52(2):154-6.
Patients with hyperlipoproteinaemia or spontaneous thromboembolism, known to be poor responders to DDAVP or to venous occlusion with regard to the rise in fibrinolytic activity of the blood, appeared to show a normal increase in t-PA-antigen after the same procedure. In their plasma a higher than normal level of free, fast-acting t-PA-inhibitor was found as measured by titration with purified t-PA. This free t-PA-inhibitor level only decreased after the test, in contrast to its complete disappearance in normal responders. The same happened in a healthy volunteer who failed to exhibit a rise in fibrinolytic activity after exhaustive exercise. We suppose that the lack of response of the fibrinolytic activity in these cases is due to a high inhibitor level and not to impaired release of t-PA into the blood. In contrast, patients with terminal renal insufficiency showed only a slight increase in t-PA-antigen after DDAVP. The level of free fast-acting inhibitor was normal in most cases and did not change appreciably during DDAVP-infusion. In these patients, a true impairment of the release of t-PA appears to exist.
对于高脂血症或自发性血栓栓塞患者，已知其对去氨加压素或静脉阻塞在血液纤溶活性升高方面反应不佳，但在相同操作后，其组织型纤溶酶原激活物（t-PA）抗原似乎正常增加。通过用纯化的t-PA滴定测量发现，他们血浆中游离的、快速起效的t-PA抑制剂水平高于正常。与正常反应者中其完全消失相反，这种游离t-PA抑制剂水平仅在试验后降低。在一名力竭运动后纤溶活性未升高的健康志愿者中也出现了同样情况。我们推测，这些病例中纤溶活性缺乏反应是由于抑制剂水平高，而非t-PA释放到血液中受损。相比之下，终末期肾功能不全患者在使用去氨加压素后t-PA抗原仅略有增加。大多数情况下，游离快速起效抑制剂水平正常，在去氨加压素输注期间无明显变化。在这些患者中，似乎确实存在t-PA释放受损的情况。
