Stief T W
Thrombosis and Haemostasis Section, University Hospital of Seville, Spain.
Blood Coagul Fibrinolysis. 1993 Feb;4(1):123-5.
The susceptibility of blood to fibrinolytic activation is an important parameter to predict the possible clinical outcome of thrombolysis in routine hospital practice. This paper describes a rapid method which is based on the integrated plasmin activity of a sample and which therefore does not require standardization of different fibrinolytic factors, such as plasminogen activator inhibitor type 1. Plasma is incubated with either streptokinase, urokinase (u-PA), tissue plasminogen activator (t-PA) or plasminogen streptokinase activator complex (PSAC) at room temperature. This is followed by addition of KCl, the chromogenic plasmin substrate S-2251 and chloramine T. As a blank, KCl is added before the enzyme. The incubation time is shortened three-fold at 37 degrees C. The highest fibrinolytic activity, with the smallest standard deviation, was obtained with streptokinase. When the lowest activity measured was defined as 100%, the highest activities were 273%, 297%, 344% and 961% for streptokinase, urokinase, t-PA and APSAC respectively. The susceptibility to urokinase correlated with that of t-PA. Patients reacted differently to the different plasminogen activators. Therefore, the method allows the appropriate agent and amount to be chosen before thrombolysis is started.
在日常医院实践中，血液对纤溶激活的敏感性是预测溶栓可能临床结果的一个重要参数。本文描述了一种基于样品整合纤溶酶活性的快速方法，因此不需要对不同的纤溶因子进行标准化，如1型纤溶酶原激活物抑制剂。血浆在室温下与链激酶、尿激酶（u-PA）、组织纤溶酶原激活物（t-PA）或纤溶酶原链激酶激活物复合物（PSAC）孵育。随后加入氯化钾、发色底物S-2251和氯胺T。作为空白对照，在加入酶之前加入氯化钾。在37℃下孵育时间缩短了三倍。链激酶获得了最高的纤溶活性，标准差最小。当测得的最低活性定义为100%时，链激酶、尿激酶、t-PA和APSAC的最高活性分别为273%、297%、344%和961%。对尿激酶的敏感性与对t-PA的敏感性相关。患者对不同的纤溶酶原激活物反应不同。因此，该方法允许在开始溶栓之前选择合适的药物和剂量。
