Complexing of tissue plasminogen activator with PAI-1, alpha 2- macroglobulin, and C1-inhibitor: studies in patients with defibrination and a fibrinolytic state after electroshock or complicated labor

摘要: Release of tissue plasminogen activator (t-PA) and its interaction with plasma protease inhibitors were studied in two patients massive defibrination, one after electroshock soft injury the other complicated labor; both had very severe hemorrhage. Large quantities free t-PA present circulation for several hours. Complexes inhibitor 1 (PAI- 1), alpha 2-macroglobulin C1-inhibitor also observed. PAI-1 antigen rose dramatically patients, complexes rapidly during period observation. In contrast, C1-inhibitor, initially, persisted short periods only disappeared when t- PA from circulation. Plasmin was generated as indicated by presence plasmin-alpha 2-antiplasmin complexes. Plasma concentrations 2-macroglobulin, antithrombin III, severely depleted but returned to normal. The observations demonstrate that there is a major release such defibrinating role than regulation endogenous t-PA, indicate great rapidity which complexed cleared.