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白塞病患者血浆血管性血友病因子、组织型纤溶酶原激活物、纤溶酶原激活物抑制剂及抗凝血酶III水平

Plasma von Willebrand factor, tissue plasminogen activator, plasminogen activator inhibitor, and antithrombin III levels in Behçet's disease.

作者信息

Ozoran K, Dügün N, Gürler A, Tutkak H, Tokgöz G

机构信息

Ankara University, Faculty of Medicine, Ibni Sina Hospital, Department of Immunology, Turkey.

出版信息

Scand J Rheumatol. 1995;24(6):376-82. doi: 10.3109/03009749509095184.

Abstract

Sixty-three patients with Behçet's disease (BD), 30 patients with recurrent oral ulcer and 30 healthy individuals as control group were included in the study. ISG criteria was used for the diagnosis of BD and patients were classified as active and inactive and evaluated accordingly. In the patient and control groups, von Willebrand factor (vWF), tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI) levels were determined using ELISA method and antithrombin III (AT-III) by nephelometric methods. High levels of endothelial product, vWF in the active Behçet patient group (p < 0.005) supports endothelial destruction due to vasculitis related with BD. In the active patient group tPA levels were significantly lower (p < 0.05) than the inactive and control groups with higher levels of PAI (p < 0.05 and p < 0.01) respectively. In Behçet disease, besides the decrease in tPA synthesis, high PAI levels also can affect tPA decrease and lead to inhibition of fibrinolytic activity. In active Behçet group, levels of AT-III were low and no significant difference was observed in recurrent oral ulcer and control groups. This situation may arise from the excessive use of AT-III in active disease. In conclusion, high levels of vWF in Behçet patients is thought to arise from vasculitis and high levels of PAI from the accumulation of thrombocytes on the damaged surface of endothelium leading to a decrease in tPA levels and inhibition of fibrinolytic activity.

摘要

本研究纳入了63例白塞病(BD)患者、30例复发性口腔溃疡患者以及30名健康个体作为对照组。采用国际白塞病研究组(ISG)标准诊断BD,并将患者分为活动期和非活动期,进而进行相应评估。在患者组和对照组中,采用酶联免疫吸附测定(ELISA)法测定血管性血友病因子(vWF)、组织型纤溶酶原激活剂(tPA)以及纤溶酶原激活剂抑制剂(PAI)水平,采用散射比浊法测定抗凝血酶III(AT-III)水平。活动期白塞病患者组中高水平的内皮产物vWF(p < 0.005)支持了与BD相关的血管炎导致的内皮破坏。活动期患者组的tPA水平显著低于非活动期组和对照组(p < 0.05),而PAI水平则分别较高(p < 0.05和p < 0.01)。在白塞病中,除了tPA合成减少外,高PAI水平也会影响tPA降低并导致纤溶活性受到抑制。活动期白塞病组中AT-III水平较低,而复发性口腔溃疡组和对照组中未观察到显著差异。这种情况可能源于活动期疾病中AT-III的过度消耗。总之,白塞病患者中高水平的vWF被认为源于血管炎,而高水平的PAI则源于血小板在受损内皮表面的积聚,导致tPA水平降低和纤溶活性受到抑制。

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