Seitz R, Lerch L, Immel A, Egbring R
Department of Haematology/Oncology, Philipps University Hospitals, Marburg, Germany.
Ann Clin Biochem. 1995 Mar;32 ( Pt 2):193-5. doi: 10.1177/000456329503200211.
Both plasmin and elastase, a protease released from neutrophil granulocytes, are known to degrade fibrin(ogen). This raises the possibility that elevated plasma levels of split products such as D-dimer may in part result from elastase action. After incubation in vitro of fibrinogen and fibrin clots with elastase, a clearcut increase of D-dimer immunoreactivity was demonstrated by two commercial ELISA kits. In the plasma of 79 patients with inflammatory bowel disease, D-dimer values measured by one of the ELISA kits were correlated significantly not only with markers of thrombin and plasmin activation, but also with elastase-alpha 1-antitrypsin complexes (r = 0.3555; P = 0.014). Thus, the findings of this study suggest that indeed the D-dimer levels in patients with inflammatory disorders are influenced by neutrophil elastase. New tests discriminating effects of activated haemostasis from proteolysis by neutrophil enzymes might be helpful in differential diagnosis and monitoring of therapy.
纤溶酶和弹性蛋白酶（一种从中性粒细胞释放的蛋白酶）都已知可降解纤维蛋白（原）。这就增加了一种可能性，即诸如D - 二聚体等裂解产物的血浆水平升高可能部分是由弹性蛋白酶的作用导致的。在用弹性蛋白酶对纤维蛋白原和纤维蛋白凝块进行体外孵育后，两种商用酶联免疫吸附测定（ELISA）试剂盒均显示D - 二聚体免疫反应性明显增加。在79例炎症性肠病患者的血浆中，其中一种ELISA试剂盒测得的D - 二聚体值不仅与凝血酶和纤溶酶激活的标志物显著相关，而且与弹性蛋白酶 - α1 - 抗胰蛋白酶复合物相关（r = 0.3555；P = 0.014）。因此，本研究结果表明，炎症性疾病患者的D - 二聚体水平确实受中性粒细胞弹性蛋白酶影响。区分活化止血作用与中性粒细胞酶蛋白水解作用的新检测方法可能有助于鉴别诊断和治疗监测。
