Hansen A, Whitelaw A, Lapp C, Brugnara C
Joint Program in Neonatology, Children's Hospital, Boston, MA, USA.
Acta Paediatr. 1997 Sep;86(9):995-8. doi: 10.1111/j.1651-2227.1997.tb15186.x.
Intraventricular fibrinolytic enhancement with plasminogen activators is an experimental treatment for posthaemorrhagic hydrocephalus, but some infants do not respond. The objectives of this study were to investigate whether plasminogen activator inhibitor-1 is detectable in normal or posthaemorrhagic neonatal cerebrospinal fluid and whether higher neonatal cerebrospinal fluid concentrations of plasminogen activator inhibitor-1 are associated with failure of fibrinolytic therapy. Cerebrospinal fluid samples from 7 controls and 16 infants with posthaemorrhagic hydrocephalus (15 treated with exogenous fibrinolytic agents) were analysed for plasminogen activator inhibitor-1. Plasminogen activator inhibitor-1 was not detectable in any of the control samples but was detectable in all but one of the posthaemorrhagic samples, and at significantly higher levels in the treatment failures (median 94 ng ml(-1)) than in the treatment successes (median 25 ng ml(-1)). High levels of plasminogen activator inhibitor-1 in the cerebrospinal fluid are predictive of, and provide a plausible biological explanation for, failure of intraventricular fibrinolytic therapy.
使用纤溶酶原激活剂增强脑室内纤维蛋白溶解作用是治疗出血后脑积水的一种实验性疗法，但一些婴儿对此无反应。本研究的目的是调查在正常或出血后的新生儿脑脊液中是否可检测到纤溶酶原激活剂抑制剂-1，以及新生儿脑脊液中较高浓度的纤溶酶原激活剂抑制剂-1是否与纤维蛋白溶解疗法的失败有关。对7名对照婴儿和16名出血后脑积水婴儿（其中15名接受了外源性纤维蛋白溶解剂治疗）的脑脊液样本进行了纤溶酶原激活剂抑制剂-1分析。在任何对照样本中均未检测到纤溶酶原激活剂抑制剂-1，但在除一份出血后样本外的所有样本中均可检测到，且治疗失败组（中位数94 ng/ml）的水平显著高于治疗成功组（中位数25 ng/ml）。脑脊液中高水平的纤溶酶原激活剂抑制剂-1可预测脑室内纤维蛋白溶解疗法的失败，并为其提供了一个合理的生物学解释。
