格雷夫斯病中内皮组织纤溶酶原激活物释放受损——内皮功能障碍和纤溶能力降低的指标。

Impaired release of tissue plasminogen activator from the endothelium in Graves' disease - indicator of endothelial dysfunction and reduced fibrinolytic capacity.

作者信息

Li Y, Chen H, Tan J, Wang X, Liang H, Sun X

机构信息

Affiliated Hospital of Zunyi Medical School, Zunyi 563003, China.

出版信息

Eur J Clin Invest. 1998 Dec;28(12):1050-4. doi: 10.1046/j.1365-2362.1998.00381.x.

DOI:10.1046/j.1365-2362.1998.00381.x

PMID:9893018

Abstract

BACKGROUND

Patients with hyperthyroidism have increased plasma levels of von Willebrand factor (vWF). Changes in tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1), another two endothelium-derived proteins and modulators of blood fibrinolytic activity, have not been reported in hyperthyroidism.

METHODS

The release of t-PA by vascular endothelial cells after venous occlusion, basal blood concentrations of t-PA, PAI-1 and vWF were studied in 33 patients with hyperthyroidism, with most of them followed up 30 days after iodine radiotherapy.

RESULTS

Compared with control subjects, both the basal t-PA levels in plasma and the increase in t-PA levels with venous occlusion were significantly decreased in patients (P < 0.001), whereas plasma PAI-1 and vWF levels were increased greatly (P < 0.001). At follow-up, patients with normal plasma free thyroxine (T4) and total tri-iodothyronine (T3) showed similar plasma levels of t-PA, PAI-1, vWF and release of t-PA from endothelial cells as the control subjects (P > 0.05). In those with persistent elevated T4 or T3 levels, however, the basal plasma t-PA level and the released t-PA from endothelial cells during venous occlusion were significantly lower than in the control subjects (P < 0.001 and P < 0.005), and blood concentrations of PAI-1 and vWF did not return to the normal range (P < 0.001 and P < 0.001). In all patients, serum thyroid hormone concentrations were inversely correlated with basal plasma t-PA (T4: r = -0.549, P < 0. 001; T3: r = -0.463, P < 0.001) and released t-PA by endothelial cells (T4: r = -0.505, P < 0.001; T3: r = -0.450, P < 0.001) but strongly correlated with plasma PAI-1 (T4: r = 0.613, P < 0.001; T3: r = 0.577, P < 0.001) and vWF (T4: r = 0.457, P < 0.001; T3: r = 0. 564, P < 0.001).

CONCLUSION

Hyperthyroid patients may experience vascular endothelial dysfunction and reduced fibrinolytic activity in blood.

摘要

背景

甲状腺功能亢进患者血浆中血管性血友病因子（vWF）水平升高。组织纤溶酶原激活物（t-PA）和纤溶酶原激活物抑制剂（PAI-1）是另外两种内皮细胞衍生的蛋白，也是血液纤溶活性的调节因子，甲状腺功能亢进患者中这两种蛋白的变化尚未见报道。

方法

对33例甲状腺功能亢进患者进行研究，观察静脉阻塞后血管内皮细胞释放t-PA的情况，以及t-PA、PAI-1和vWF的基础血浓度，其中大多数患者在碘放疗后随访30天。

结果

与对照组相比，患者血浆中基础t-PA水平以及静脉阻塞时t-PA水平的升高均显著降低（P<0.001），而血浆PAI-1和vWF水平大幅升高（P<0.001）。随访时，血浆游离甲状腺素（T4）和总三碘甲状腺原氨酸（T3）正常的患者，其血浆t-PA、PAI-1、vWF水平以及内皮细胞释放t-PA的情况与对照组相似（P>0.05）。然而，T4或T3水平持续升高的患者，其基础血浆t-PA水平以及静脉阻塞时内皮细胞释放的t-PA显著低于对照组（P<0.001和P<0.005），PAI-1和vWF的血浓度未恢复到正常范围（P<0.001和P<0.001）。在所有患者中，血清甲状腺激素浓度与基础血浆t-PA（T4：r=-0.549，P<0.001；T3：r=-0.463，P<0.001）和内皮细胞释放的t-PA（T4：r=-0.505，P<0.001；T3：r=-0.450，P<0.001）呈负相关，但与血浆PAI-1（T4：r=0.613，P<0.001；T3：r=0.577，P<0.001）和vWF（T4：r=0.457，P<0.001；T3：r=0.564，P<0.001）呈强正相关。