视网膜静脉阻塞患者血浆t-PA和PAI活性检测及临床意义

采用发色底物法检测61例视网膜静脉阻塞(RVO)患者血浆组织纤溶酶原激活剂(t-PA)及纤溶酶原激活剂抑制物(PAI)活性．正常对照组t-PA活性2.07±0.40IU/ml，PAI活性7.33±0.69AU/ml。RVO患者t-PA活性显著降低(1.69±0.56IU/ml，P<0.01)，PAI活性显著增高(8.80±1.60AU/ml，P<0.01)．其中缺血型较非缺血型t-PA活性吏低(分别为1.35±0.43IU/ml，1.92±0.53IU/ml，P<0，01)，PAI活性更高(分别为9.35±1.37IU/ml，8.42±1.29IU/ml，P<0.01)。并且，这些改变随病情严重程度的加重而愈显著． （中华眼底病杂志，1994，10：71-73）     

中心性浆液性脉络膜视网膜病变的相关因素研究

为了探讨中心性浆液性脉络膜视网膜病变(简称中浆)的病因和发病机制,我们同期检测了48例中浆患者活动期及恢复期血浆糖皮质激素(glucocorticoids,GC)、儿茶酚胺(catecholamines,CA)、组织型纤溶酶原激活剂(tissueplasminogenactivator,tPA)、纤溶酶原激活剂抑制物(plasminogenactivatorihibitor,PAI)浓度及活性变化,并分析其相互关系,探讨这些因素在中浆发生和发展中的作用。1　临床资料和方法研究对象:1中浆组:通过直接检眼镜,Amsler表及荧光素眼底血管造影确诊。筛选条件是:病程不超过10d,2周内未使用皮质类固醇类药物,不合并其它疾患…     

血栓通联合等容血液稀释治疗视网膜静脉阻塞对纤溶活性及血液流变学的影响

目的探讨血栓通(panax notoginsang　saponins,PNS)、等容血液稀释(isovalaemic haemodilution,IHD)以及二者联合治疗视网膜静脉阻塞(retinal vein occlusion,RVO)的效果。方法采用PNS、IHD及二者联合随机对照治疗RVO患者73例，观察治疗前后患者血浆组织型纤溶酶原激活物(tissue plasminogen activator,t-PA)及其抑制物(plasminogen activator inhibitor,PAI)活性、血液流变学参数及视力的改变。结果治疗结束时，PNS+IHD组和PNS组较治前t-PA活性增高；PAI活性降低；IHD组t-PA活性和PAI活性改变不明显；除IHD组血浆粘度变化不明显外，三组患者血液流变学指标均有不同程度改善。治疗后1个月，PNS+IHD组全血低切粘度、低切还原粘度和红细胞聚集指数及其聚集力较治疗前仍有显著差异；且视力改善亦较快、较好。结论PNS联合IHD治疗RVO具有调节机体纤溶功能和较持久地降低血液粘度，提高治疗效果的作用。(中华眼底病杂志,1998,14:7-9)     

PDR患者血浆、眼内组织纤溶酶原激活物及其抑制剂与VEGF的表达及相关性

目的 探讨增殖性糖尿病视网膜病变(proliferativediabeticretinopathy,PDR)患者血浆、房水、玻璃体中血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)与组织纤溶酶原激活物(tissuetypeplasminogenactivator,tPA)及tPA抑制剂(plasminogenactivatorinhibitor,PAI)的表达,并评价VEGF表达与tPA、PAI的相关性。方法 采用双抗体夹心酶联免疫吸附试验(ELISA)法定量检测来自宁夏医科大学总医院眼科的PDR组及对照组患者血浆、房水、玻璃体中VEGF、tPA、PAI的含量。结果 PDR组血浆中VEGF(63.12±16.25)pgmL-1、PAI(10.27±7.62)ngmL-1的表达均高于对照组(14.39±10.48)pgmL-1、(0.28±0.11)ngmL-1,差异均有统计学意义(均为P<0.051;PDR组血浆中tPA(19.91±9.90)ngmL-1与对照组(12.00±2.61)ngmL-1比较差异无统计学意义(P>0.01)。PDR组房水中VEGF(291.21±45.04)pgmL-1、tPA(5.38±240)ngmL-1、PAI(0.53±0.31)ngmL-1均高于对照组(30.60±11.70)pgmL-1、(3.87±1.32)ngmL-1、(0.16±0.09)ngmL-1,差异均有统计学意义(均为P<0.05);PDR组玻璃体中VEGF(527.62±79.00)pgmL-1、tPA(10.41±6.33)ngmL-1、PAI(7.72±2.32)ngmL-1的表达浓度均高于对照组(37.58±8.31)pgmL-1、(3.68±2.48)ngmL-1、(0.27±013)ngmL-1,差异均有统计学意义(均匀P<0.05)。PDR组自身血浆、房水、玻璃体三者比较,VEGF表达:玻璃体>房水>血浆;tPA表达:血浆>玻璃体>房水;PAI表达:血浆、玻璃体均高于房水,但血浆和玻璃体比较差异无统计学意义(P>005)。眼科新进展 2014年7月 第34卷 第7期PDR组血浆、房水、玻璃体中VEGF的表达与tPA及PAI的表达均存在显著相关性(均为P<0.05)。结论 VEGF、tPA、PAI可能参与了PDR视网膜新生血管的发生过程;VEGF与tPA     

视网膜静脉阻塞患者高凝状态的检测分析

检测36例早期视网膜静脉阻塞(RVO)患者和20例正常人的血小板聚集与释放功能、血浆凝血因子和纤溶活性。结果,RVO患者的血小板聚集率、血浆纤维连接蛋白、因子Ⅷ相关抗原和纤溶酶原均高于正常人。表明RVO患者的血液呈高凝状态。这种血液凝固性异常可能在RVO的发生发展及其缺血性并发症上起重要作用。     

视网膜静脉阻塞患者血浆t－pA和PAI活性检测及临床意义

采用发色底物法检测６１例视网膜静脉阻塞（ＲＶＯ）患者血浆组织纤溶酶原激活剂（ｔ－ＰＡ）及纤溶酶原激活剂抑制物（ＰＡＩ）活性。正常对照组ｔ－ｐＡ活性２．０７±０．４０ＩＵ／ｍｌ，ＰＡＩ活性７．３３±０．６７ＡＵ／ｍｌ。ＲＶＯ患者ｔ－ＰＡ活性显著降低（１．６９±０．５６ＩＵ／ｍｌ，ｐ＜０．０１），ＰＡＩ活性显著增高（８．８０±１．６０ＡＵ／ｍｌ，Ｐ＜０．０１）。其中缺血型较非缺血型ｔ－ｐＡ活性更低（分别为１．３５±０．４３ＩＵ／ｍｌ，１．９２±０．５３ＩＵ／ｍｌ，Ｐ＜０．０１），ＰＡＩ活性更高（分别为９．３５±１．３７ＩＵ／ｍｌ，８．４２±１．２９ＩＵ／ｍｌ，Ｐ＜０．０１）．并且，这些改变随病情严重程度的加重而愈显著。     

增殖性糖尿病视网膜病变眼内组织纤溶酶原激活物及其抑制物的表达与VEGF表达的相关性研究

目的:探讨增殖性糖尿病视网膜病变(PDR)中组织纤溶酶原激活物(t-PA)及纤溶酶原激活物抑制剂(PAI)的表达以及与血管内皮生长因子(VEGF)表达的相关性.方法:于玻璃体手术中采集PDR 35眼玻璃体,同时采集因黄斑裂孔行玻璃体手术20眼玻璃体作为对照组,采用酶联免疫吸附法检测t-PA及PAI的表达浓度,并与VEGF的表达进行相关性分析.结果:PDR眼玻璃体中VEGF、t-PA及PAI的表达浓度均显著高于对照眼玻璃体(P＜0.001).t-PA及PAI的表达与VEGF的表达经统计学分析,均存在显著相关性(P＜0.001).结论:在PDR眼内视网膜新生血管的发生过程中不仅有VEGF,可能同时有多种生物活性物质的参与.     

不同分期糖尿病视网膜病变患者外周血中AT-Ⅲ、PAI、t-PA变化的研究

目的：寻找糖尿病视网膜病变不同分期与血管内皮功能的相关因子之间的内在联系,从改善血管内皮功能方面为寻找延缓甚至抑制DR的发生或进展的方法提供理论依据。

方法：收集2015-03/12在本院眼科及内分泌科住院的2型糖尿病患者178例及健康对照组62例的血样标本; 根据眼底血管荧光造影(FFA)结果糖尿病组患者可分为无视网膜病变组、非增殖性视网膜病变组、增殖性视网膜病变组; 检测血样标本中抗凝血酶Ⅲ(AT-Ⅲ)、纤溶酶原激活抑制物(PAI)、组织型纤溶酶原激活剂(t-PA)指标与糖尿病视网膜病变分期的相关性。

结果：本研究表明无糖尿病视网膜病变组、非增殖期糖尿病视网膜病变组、增殖期糖尿病视网膜病变组及对照组 AT-Ⅲ比较,差异具有统计学意义(F=5.986,P<0.01); 无糖尿病视网膜病变组、非增殖期糖尿病视网膜病变组、增殖期糖尿病视网膜病变组、对照组PAI 比较,差异具有统计学意义(F=7.434,P<0.01); 无糖尿病视网膜病变组、非增殖期糖尿病视网膜病变组、增殖期糖尿病视网膜病变组及对照组t-PA比较,差异无统计学意义(F=2.556,P>0.05)。糖尿病视网膜病变的程度与AT-Ⅲ、PAI的含量有着密切的关系。

结论：糖尿病视网膜病变发生程度与抗凝血酶Ⅲ、纤溶酶原激活抑制物的含量有着密切的关系,与血管内皮功能也有着密不可分的联系。     

缺血再灌注大鼠视网膜TPA及其抑制物的变化

目的观察缺血再灌注时大鼠视网膜分泌组织型纤溶酶原激活剂(tissue-type-asminogen activator,TPA)和TPA抑制物(plasminogen activatorinhibitor,PAI)的变化,并探讨其意义.方法采用提高眼压法造成视网膜缺血后,恢复眼压形成血流再灌注.实验分5组:正常对照组、缺血1 h再灌注1 h组、缺血1 h再灌注2 h组、缺血2 h再灌注1 h组和缺血2 h再灌注2 h组,每组各取10例测试视网膜组织TPA和PAI的活性.结果缺血再灌注后,大鼠视网膜组织TPA的活性随缺血和再灌注时间的延长而升高(P＜0.01);PAI的活性无显著性变化(P>0.05);TPA/PAI的比值随缺血和再灌注时间的延长而增大(P＜0.01).结论缺血再灌注引起视网膜组织TPA活性的升高,TPA和PAI动态平衡受破坏,是导致视网膜组织水肿和损伤的因素之一.     

组织纤维蛋白溶酶原激活剂结膜下注射的眼内浓度

组织纤维蛋白溶酶原激活剂(tPA),分子量为70 000道尔顿,是一种对纤维蛋白凝块的特异性溶解剂。以往的研究表明,在人和动物前房内注射tPA后,可使术后和实验性的眼内纤维蛋白溶解。业已证实,局部应用tPA     

Changes of Plasma tPA and PAI Activities in Patients with Diabetic Retinopathy

Purpose:To investigate the relationship between the diabetic retinopathy (DR) and the activity of plasma tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI).Methods :tPA and PAI activities were measured by chromatogenous substrate assay in plasma samples obtained from patients with and without diabetic retinopathy (n = 42). Retinopathy was determined by stereoscopic color fundus photographs graded according to a modification of Chinese National Fundus Disease Academic Meeting. And 21 sex-age matched normal people were as controls. This study was in a masked fashion.Results:①tPA activity was lower and PAI activity was higher in all of diabetic patients than those in controls (P<0. 001); ②tPA activity was lower and PAI activity was higher in proliferative DR (PDR) subgroup than those in non-DR (NDR) and background-DR (BDR) subgroups (P<0.01,respectively); ③there was no significant difference between BDR and NDR subgroups (P>0. 05); and ④the results also suggested that the seve     

Roles of tissue plasminogen activator and its inhibitor in proliferative diabetic retinopathy

AIM:To investigate the role of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) in proliferative diabetic retinopathy (PDR) and to discuss the correlations among t-PA, PAI and vascular endothelial growth factor (VEGF) expressions.METHODS: A total of 36 vitreous samples were collected from 36 patients with PDR (PDR group), and 17 vitreous samples from 17 patients with idiopathic macular hole were used as control. The concentrations of t-PA, PAI and VEGF in samples were determined by ELISA method. The correlations among t-PA, PAI and VEGF expressions were discussed.RESULTS: The concentrations of t-PA, PAI and VEGF in the PDR group were significantly higher than those in the control group (P<0.001). The t-PA and PAI expressions were highly correlated with the VEGF expression (P<0.001).CONCLUSION:In addition to VEGF, a variety of bioactive substances, such as t-PA and PAI, are involved in the pathogenesis involved in the angiogenesis of PDR. VEGF can activate t-PA expression, resulting in collagen tissue degradation and angiogenesis. VEGF may also activate the mechanism for endogenous anti-neovascularization.     

糖尿病视网膜病变患者血液流变学变化及意义

为探讨糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）发生发展的有关因素，而对３４例ＤＲ患者，２０例糖尿病无ＤＲ患者及３０例正常人的血液流变学指标进行了检测，结果糖尿病组血浆纤维蛋白原，血液粘度，红细胞聚集指数均明显高于正常对照线，血液触变指标则低于正常对照组，这些变化在ＤＲ组患者更为显著，提示：ＤＲ的发生发展与血液为学异常所致的微循环功能障碍有关。     

Fibrinolytic activity in retinal vein occlusion

Purpose: Impaired fibrinolytic function is a common finding in patients with thrombotic disease. The present study was initiated to evaluate the fibrinolytic response to a venous occlusion test (VOT) in patients with retinal vein occlusion. Methods: Euglobulin clot lysis time (ECLT), tissue plasminogen activator (t-PA) activity, and plasminogen activator inhibitor (PAI) activity were measured before and after VOT in a group of 26 consecutive patients presenting with retinal vein occlusion and in 15 healthy age- and sex-matched controls. Results: Before VOT (baseline), a higher proportion of patients (54%) had an ECLT of more than 5 h compared with controls (6.7%)(p = 0.0027) indicating decreased overall fibrinolytic activity. Patients had non-significantly lower t-PA and higher PAI activities compared with controls. After VOT, a higher proportion of patients (34.6%) had an ECLT of more than 5 h compared with controls (6.7%) (p = 0.05). Patients had significantly lower t-PA activity (p = 0.0232) and significantly higher PAI activity (p = 0.0292).Subgroup analysis revealed that patients with an ECLT of more than 5 h had significantly higher levels of PAI activity at baseline (p =0.0326) and after VOT (p = 0.0184) compared with patients with an ECLT of less than 5 hours. However, t-PA activity was significantly higher(p = 0.0153) at baseline, and non-significantly higher after VOT in patients with an ECLT of more than 5 h when compared with patients with an ECLT of less than 5 hours. Conclusions: These findings suggest that impaired fibrinolysis due to increased PAI activity may play a role in the pathogenesis of retinal vein occlusion. This revised version was published online in August 2006 with corrections to the Cover Date.     

Maspin increases extracellular plasminogen activator activity associated with corneal fibroblasts and myofibroblasts

Maspin, an inhibitor of cell migration and a stimulator of adhesion of cells to the ECM, is synthesized and released by corneal keratocytes into the extracellular matrix. When the cornea is wounded, the quiescent stromal keratocytes underlying the wound undergo apoptosis and cells adjacent to this apoptotic area convert to fibroblasts or myofibroblasts. This study explores the effect of extracellular maspin on the plasminogen–plasminogen activator system of corneal stromal cells following wounding. Treatment of corneal fibroblasts and myofibroblasts with r-maspin increased extracellular but not cell-associated tissue-type plasminogen activator (tPA), urinary-type plasminogen activator (uPA) or plasminogen activator inhibitor-1 (PAI-1). Despite the extracellular increase in PAI-1, the net effect of maspin treatment was an increase in plasminogen activation. At physiological levels, maspin did not alter uPA or tPA mRNA levels, in these cells. The increase in pro and active uPA was due to decreased clearance in the presence of maspin for myofibroblasts but not for fibroblasts. The clearance of pro and active tPA was normal in fibroblasts indicating different mechanisms for the increase of these homologous enzymes in the two cell types. Increased generation of plasmin by maspin treated corneal stromal fibroblasts and myofibroblasts led to conversion of plasminogen to active plasmin degradation products and angiostatin-like molecules. This study suggests that extracellular maspin increased pro and active uPA and tPA released by corneal fibroblasts and myofibroblasts on the short time scale of 1–4 h, but by 24 h there was no increase over the levels produced without maspin. This augmentation of plasminogen activator activity increases plasmin activation and angiostatin generation. It further indicates that the effect of maspin on uPA and tPA levels is cell type dependent.     

Comparative evaluation of blood viscosity in diabetic retinopathy

The viscosity of the whole blood, plasma and serum, haematocrit and plasma fibrinogen were studied in diabetic patients with (DR) and without (D) retinopathy and in non-diabetic control subjects (C). Blood viscosity was significantly higher in diabetics than in controls.No significant differences in viscosity of the whole blood were found when various types of retinopathy were compared according to the severity of retinal damage.Plasma viscosity was significantly higher (P < 0.01) than controls (C) only in diabetic patients with retinopathy (DR). Serum viscosity was significantly increased compared with controls (C) only in diabetic patients affected by proliferative retinopathy.Plasma fibrinogen was significantly higher than controls (C) both in diabetics with retinopathy (DR) and without retinopathy (D).Haematocrit did not show a significant difference in the three groups considered (C, D, DR).     

雷珠单抗联合激光光凝治疗PDR及对房水中PAI、t-PA、VEGF水平的影响

目的:研究雷珠单抗联合激光治疗增殖性糖尿病视网膜病变(PDR)疗效及对患者房水纤溶酶原激活物抑制剂(PAI)、组织溶酶原激活物(t-PA)、血管内皮生长因子(VEGF)水平的影响。方法:选取2015-03/2017-03我院PDR患者76例76眼,根据治疗方法不同分为全视网膜光凝(PRP)治疗前行玻璃体腔注射雷珠单抗治疗组(观察组)和单纯PRP治疗组(对照组),比较两组患者治疗时所用激光能量和密度以及治疗后患者最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、房水中PAI、t-PA、VEGF水平、术后并发症及预后情况。结果:观察组光斑数量、激光能量和能量密度均低于对照组(P<0.05);治疗后,两组BCVA逐渐升高,CMT逐渐降低,组内不同时间差异有统计学意义(P<0.05),且观察组同一时间BCVA高于对照组,CMT低于对照组(P<0.05);治疗后,两组患者房水中VEGF、t-PA和PAI水平逐渐升高,但均明显低于术前水平(P<0.05),组内不同时间差异有统计学意义(P<0.05),且观察组同一时间房水中VEGF、t-PA和PAI水平低于对照组(P<0.05);两组术后黄斑水肿发生率分别为17%和37%(P<0.05)。两组患者术后1a PDR复发率分别为6%和16%(P>0.05)。结论:雷珠单抗联合激光治疗PDR能明显降低房水中VEGF、t-PA和PAI表达水平,降低患者CMT,改善患者BCVA,同时联合治疗有利于减少激光治疗时光斑数量、激光能量和能量密度,降低激光对视网膜损害。     

外周血循环内皮细胞、血浆内皮素与糖尿病视网膜病变的关系

目的 探讨血管内皮细胞(vascular endothelial cells,VEC)损伤及损坏后的功能变化在糖尿病视网膜病变(diabetic retinopathy,DR)发病机制中的作用。 方法 检测55例糖尿病(diabetes mellitus,DM)患者(包括无视网膜病变组20例,背景型视网膜病变组20例,增生型视网膜病变组15例)及正常人外周血循环内皮细胞(circulating endothelial cells ,CEC)数及血浆内皮素 (endothelin,ET)水平变化,并进行比较。 结果 DM患者CEC数及ET水平显著高于正常人(P<0.001),两指标呈显著正相关(r=0.738,P<0.001,n=55)。CEC数及ET水平随DR程度加重而增高。 结论 VEC损伤及由此所致的血浆ET水平增高,可能共同参与了DR的病理过程。(中华眼底病杂志,2000,16:166-168)