各種血液疾患，肝疾患，糖尿病，こう原病，血栓性疾患およびＤＩＣにおける組織プラスミノゲンアクチベーター（ｔ‐ＰＡ）の動態 ｏｎｅ‐ｓｔｅｐ ＥＬＩＳＡによる血しょうｔ‐ＰＡの定量

Abstract

Plasma antigen levels of tissue plasminogen activator (t-PA) were measured by a newly developed one-step sandwich enzyme-linked immunosorbent assay (ELISA) together with plasmin-α2-plasmin inhibitor complex (PAP) and other coagulation parameters in patients with hematologic disease, liver disease, diabetes mellitus, collagen disease, thrombotic disease and disseminated intravascular coagulation (DIC). The mean plasma levels of t-PA and PAP in 20 normal subjects were 6.12±SD 2.41ng/ml and 0.18±0.13μg/ml, respectively. Plasma t-PA was elevated in a variety of diseases, especially in DIC (28.3±20.2ng/ml), liver disease (26.5±18.0ng/ml) and thrombotic disease (16.2±13.6ng/ml). Plasma PAP was increased as well in various diseases studied. Marked elevations in PAP were found in DIC (especially DIC associated with leukemia and vascular diseases) and thrombotic disease (especially deep vein thrombosis and pulmonary embolism). On the whole, t-PA values correlated positively with von Willebrand factor antigen, indicating that both are endothelial markers released by common stimuli. The correlation between t-PA and PAP was poor, suggesting that other factors participate in the process of plasmin generation after the release of t-PA from endothelial cells into the circulation. In addition, plasma levels of t-PA and PAP elevated following venous occlusion or DDAVP infusion. These findings indicate that measurement of t-PA would be valuable for the assessment of fibrinolysis in selected disease states.