Терапевтический архив (May 2012)
THE LEVELS OF PLASMINOGEN AND INHIBITOR OF PLASMINOGEN ACTIVATORS OF TYPE 1 IN ANTIPHOSPHOLIPID SYNDROME
Abstract
Aim. To estimate the levels of of plasminogen (Pg) and inhibitor of plasminogen activators of type 1 (IPA-1) in patients with antiphospholipid syndrome (APS) and to reveal correlations between their content and clinical-laboratory characteristics of APS. Material and methods. A Pg level was measured in 78 APS patients: 35 of them had systemic lupus erythematosus (SLE), 43 had primary APS and 19 with idiopathic thrombosis (IT). IPA-1 was detected in 63 APS patients: in 26, 37 and 18 patients, respectively. The control group consisted of 10 subjects free of autoimmune disease and thrombosis. The patients were matched by age. Pg and IPA-1 levels were estimated kinetically. The Pg level was stratified: normal (1.5-2.0 mcM, high (above 2.0 mcМ), low (under 1.5 mcM). Thromboses in the past occurred in 67 patients: arterial (n=32), venous (n=53), of combined localization (n=14). Results. Of 78 APS patients, Pg level was normal in 34 (44%), high in 20 (25%), low — in 24 (31%). Of 43 primary APS patients, low Pg was in 8 (19%), of 35 patients with SLE+APS — in 16 (46%) patients. A Pg concentration (1.59 [1.4; 1.98] mcM) was significantly less in APS patients with thrombosis than in patients with IT (2.4 [1.74; 2.99] mcM). Pg tended to lower levels than in the controls (1.95 [1.63; 2.26] mcM). IPA-1 varied in primary APS from 0.45 to > 1 nM, in SLE+APS from 0.44 to >1 nM, in IT —from 0.65 to 0.81 nM. The levels of active IPA-1 in all the patients with APS and IT were higher than in healthy donors and varied from 0.44 to >1 nM. Most of APS patients had high level of IPA-1 — 52 (83%) (IPA-1 from 0,1 to 1), of them 22 (85%) patients with SLE+APS and 30 (73%) — with primary APS. 11 (17%) APS patients had high IPA-1 ( >1), of them 4 (15%) with SLE+APS and 7 (27%) with primary APS. All IT patients had moderately high IPA-1 level. Conclusion. A low level of Pg in APS patients was seen significantly more frequently than in IT patients and controls and was associated with thrombosis, primarily arterial. Moderate high IPA-1 occurred in 83% of 63 APS patients, high in 17%. IT patients had moderately high IPA-1. High IPA-1 was associated in APS with thrombosis, primarily arterial.
