The Study On The Effect Of Tissue-type Plasminogen Activator And Its Inhibitor-1 On The Formation Of Pulmonary Thromboembolism

PrefacePulmonary thromboembolism(PTE) is a deadly cardiopulmonary disease, its incidence of the disease increases year after year, which threatens health and life of patients, it has become one of domestic and overseas questions about medical treatment and health care. Because its clinical manifestations and routine auxiliary examinations lack specificity,regularly, final diagnosis of PTE need turn to diversiform imageological technology, such as computer tomography (CT),magnetic resonance imaging (MRI) and angiography. These imageological examinations are more expensive and patients are too serious or the conditions in hospitals are too limited to make these examinations; also they are insensitive in the early diagnosis.Our research began with the theory of Virchow, investigating tissue-type plasminogen activator antigen (t-PA:Ag) and plasminogen activator inhibitor-1 antigen (PAI-l:Ag) in PTE patients,the-high-risk-factor group and the control group, discussing the effect of t-PA:Ag and PAI-l:Ag on the formation of PTE, further ,analysising early diagnostic values in PTE population , focused on t-PA:Ag and PAI-1:Ag.Materials and Methods1. Materials (1) Subjects: Stored up blood of 25 PTE patients (the PTE group),28 people with high risk factors for PTE (the high-risk-factor group) and 24 healthy people ( the control group).(2) Reagents and Instrutments: human t-PA:Ag and PAI-l:Ag ELISA kits, MODEL 550 microplate reader, LD4-2A high-rate centrifuge et al.2. MethodsCollected venous blood of the subjects, then centrifuged and stored samples in -70℃refrigerator, detected t-PA:Ag and PAI-l:Ag by ELISA method. t-PA:Ag and PAI-1:Ag between three groups were compared by ANOVA and SNK. Influences on PTE by t-PA:Ag and PAI-l:Ag were analysed by Logistic regression. Receiver-operating-characteristic curve (ROC) analysed and calculated indices such as area under curve(AUC), optimal operating point(OOP), sensitivity and specificity were used to evaluate and compare the early diagnostic values of t-PA:Ag and PAI-l:Ag in PTE.Results1.The levels of t-PA:Ag and PAI-l:Ag in the PTE group and the high-risk-factor group were significantly higher than those in the control group (P<0.05), the level of t-PA:Ag in the PTE group was appreciably lower than it in the high-risk-factor group (P>0.05); the level of PAI-l:Ag in the PTE group was higher than it in the high-risk-factor group and reached markedly differences (P<0.01).2.Logistic regression analysis indicated that PAI-1.Ag had important influence on the formation of PTE (P<0.01), the value of OR was 1.317.3.Used by ROC curve analysis, AUC for t-PA:Ag and PAI-l:Ag were 0.485 and 0.834, respectively, but only PAI-l:Ag was of value in the diagnosis of PTE (P<0.05). Setted the OOP with high sensitivity, when PAI-l:Ag≥50.39ng/mL, sensitivity and specificity were 92% and 50%, respectively.Conclusions1.Fibrinolytic indices of t-PA:Ag and PAI-l:Ag had already changed in the prethrombotic state before PTE formed, and the changes were similar to PTE.2.Between t-PA:Ag and PAI-l:Ag, PAI-l:Ag had bigger influence on the formation of PTE.3.PAI-1:Ag was of better accuracy in the early diagnosis of PTE, at the criterion of PAI-l:Ag≥50.39ng/mL, its sensitivity and specificity were 92% and 50%, respectively.