Peltonen S, Lassila R, Rossi P, Salenius J P, Lepäntalo M
Wihuri Research Institute, Helsinki, Finland.
Thromb Haemost. 1995 Dec;74(6):1442-6.
We compared hemostatic and fibrinolytic plasma markers in 41 patients having acute or subacute occlusion of lower limb arteries with 20 patients suffering stable peripheral arterial occlusive disease (PAOD). During occlusion, the amount of thrombin-antithrombin III (TAT) complex was five-fold higher compared with stable PAOD, being 16 micrograms/l [95% confidence interval (CI) 11-21 micrograms/l] vs 3 micrograms/l (95% CI 2-4 micrograms/l), p < 0.003. Similarly, D-dimer was over four-fold (p = 0.0001), while tissue plasminogen activator and plasminogen activator inhibitor-1 (PAI-1) antigens were about two-fold (p = 0.02 and p < 0.003, respectively) higher than in PAOD. Coagulation and fibrinolysis markers were increased most in patients with recent symptom onset, which mainly represented embolus rather than thrombosis. The marker levels assessing coagulation and fibrinolysis were related with myoglobin and CK, indicators of skeletal muscle damage. Finally, increased TAT, PAI-1 antigen, and myoglobin concentrations associated with poor outcome.
我们比较了41例下肢动脉急性或亚急性闭塞患者与20例患有稳定型外周动脉闭塞性疾病（PAOD）患者的止血和纤溶血浆标志物。在闭塞期间，凝血酶 - 抗凝血酶III（TAT）复合物的量比稳定型PAOD患者高五倍，分别为16微克/升[95%置信区间（CI）11 - 21微克/升]和3微克/升（95%CI 2 - 4微克/升），p < 0.003。同样，D - 二聚体超过四倍（p = 0.0001），而组织纤溶酶原激活物和纤溶酶原激活物抑制剂 - 1（PAI - 1）抗原比PAOD患者高约两倍（分别为p = 0.02和p < 0.003）。凝血和纤溶标志物在近期出现症状的患者中升高最为明显，这些患者主要表现为栓子而非血栓形成。评估凝血和纤溶的标志物水平与骨骼肌损伤指标肌红蛋白和肌酸激酶（CK）相关。最后，TAT、PAI - 1抗原和肌红蛋白浓度升高与不良预后相关。
