纤溶酶相关蛋白在急性髓性白血病血浆和骨髓中的表达

The expression of plasmin associated proteins in bone marrow and plasma in AML

目的：观察髓性白血病及正常人骨髓单个核细胞及血浆中ｕＰＡ、ｔＰＡ、ＰＡＩ的表达情况并探讨其临床意义。方法：用ＥＬＩＳＡ 法测定２０ 例急性髓性白血病及１５ 例正常人骨髓单个核细胞及血浆中ｕＰＡ、ｔＰＡ、ＰＡＩ－１、ＰＡＩ－２ 抗原表达，同时用发色底物法测定血浆中ｔＰＡ、ｕＰＡ 和ＰＡＩ－１ 的活性。结果：骨髓中ｔＰＡ 浓度白血病低于正常人（ Ｐ＜ ０．０１），血浆中相反。ｕＰＡ 浓度骨髓及血浆中白血病均高于正常人（ Ｐ＜ ０．００１）。ＰＡＩ－１ 抗原测定两者骨髓及血浆均无差别。ＰＡＩ－２ 正常人骨髓中高于白血病（ Ｐ＜ ０．０１），血浆中相反。急性髓性白血病ｕＰＡ、ｔＰＡ和ＰＡＩ－１ 血浆活性均高于正常人。结论：急性髓性白血病骨髓中ｕＰＡ 表达增高，说明白血病细胞主要表达ｕＰＡ 为主，不产生ｔＰＡ。ｔＰＡ 的释放是由于血管内皮细胞受到白血病细胞损伤引起。在急性髓性白血病患者的出血机制与ｕＰＡ、ｔＰＡ 过度表达导致纤溶亢进有关，而且白血病早期浸润可能与ｕＰＡ、ＰＡＩ的表达有关。

Objective:To investigate the uPA,tPA,PAI Ⅰ PAI Ⅱ antigen expression in bone marrow manomuclei cell (MNC) and its plasma level in AML and normal subject;furthermore to explone its clinical importance.Method:Using ELISA to determinating uPA,tPA,PAI Ⅰ PAI Ⅱ antigen in bone marrow MNC and its plasma level in 20 AML and 15 normal subject using chromophoric substract method to measure the uPA tPA PAI Ⅰ activity.Result:The tPA and PAI Ⅱ exprescion in BM MNe in AML is lower than in normal subjects while plasma level of the two factor is higher in AMI the uPA in BM MNC and its plasma level are both higher in AML.PAI Ⅰ in BM MNC and its plasma level are the same in AML and normal subject.The tPA uPA,PAI 1 activity in AMI is higher than normal.Conclusion:The hemostasis mechanism in AML is associated with high level of uPA and tPA which inducing inueased fibrinolysis.uPA is predominatly expressed in the leukemia cells and the higher tPA is mainly released by the injuried vessel endethelial cells.