[Blood coagulation and fibrinolytic indices, protein and lipid metabolism in glomerulonephritis].
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Biomedical subjects
Publications and source records attributed to G V Andreenko.
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In examination of the blood fibrinolytic and kinin systems in patients with myocardial infarction in the period of rehabilitation three groups of patients were distinguished according to fibrinolysis activity: high, normal and diminished. A positive correlative connection was noted between the activity of the fibrinolytic system and that of the kinin system. The character of changes in the indices of these systems in response to physical load depended on their initial level. Maximum increase in the fibrinolysis activator level was noted in the group of patients with low initial fibrinolytic activity, whereas in the group of patients with high initial fibrinolysis its activity after the load decreased. In assessment of the functional condition of the organism it is necessary to take into account both the initial activity of the fibrinolytic and kinin systems and the character of changes in their activity in response to physical load.
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To appraise the diagnostic significance of Innerfield's serum test, 40 patients with ischemic heart disease were examined; 18 of them had angina pectoris, 22 myocardial infarction, in the acute of subacute stage, 15 hypertensive disease, and 27 patients had rheumatic heart disease. It is shown that the blood fibrinolytic system was depressed in most patients. A shorter serum test time was characteristic of these diseases when their course was complicated by thromboembolism. With due consideration for the data on the state of the blood coagulation and anticoagulation systems, the serum test may be used for identifying the prethrombotic condition in patients with various cardiovascular diseases.
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Signs of dysfunction of the coagulation system and fibrinolysis were determined in 45 healthy young individuals who had such risk factors in relation to ischemic heart disease as arterial hypertension, hypercholesterolemia, smoking, aggravated heredity, permanent emotional overstress, etc. These signs were manifested by a tendency to augmentation of blood coagulation and compensatory activation of fibrinolysis. Ischemic-type changes were detected on the ECG after a physical load. It is assumed that dysfunction of the coagulation system and fibrinolysis is an additional risk factor in relation to ischemic heart disease, while derangement of compensatory fibrinolysis tension with the subsequent tension of its components may lead to the development of coronary thrombosis.
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A total of 41 patients with ischaemic heart disease and 30 normal donors were subjected to examinations of the biochemical indices of the blood coagulation system in its coagulation and anticoagulation links, as well as to tests reflecting the fibrinolytic and inhibitory activity of the urine. In the presence of thromboembolic complications in myocardial infarction patients a sharp elevation of "residual fibrinogen" and antiplasmins is noted along with a reduction of the urokinase activity of the urine.
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Sampling blood from the jugular, superior and inferior caval veins and the pulmonary artery and the heart ventricles of intact rats revealed that the fibrinolytic activity was the lowest in the jugular vein, while it was 1.5-2 times higher in the other sections. The fibrinolysis in these animals is 1.5 times higher in the right ventricle than in the left. One day after coronary artery ligation a reverse relationship is observed: the blood in the left ventricle has a 1.5-times higher fubinolytic activity than that in the right. The difference in the activity is due to a different plaminogen activator content. Three days after the onset of myocardium ischaemia the difference in the fibrinolytic activity of the blood in both ventricles disappears. The obtained data emphasize the role of local fibrinolysis in the development of cardiac pathology.
A possibility to fractionate fibrinolytically and thrombolytically active complex "tricholysin" into five components, differing in iso-points and in enzymatic activity, is demonstrated by means of isoelectric focusing using ampholine solution within pH range 3.0-10.0. Homogenous fraction IV (isopoint 6.8-7.0) has a low caseinolytic activity and a high specific fibrinolytic and esterase activities. This fraction is characterized with a high ability of plasminogen activation. Serine, threonine, alanine and valine are found to prevail in amino acid composition of the fraction IV, its molecular weight being 39000.
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The treatment of patients with acute myocardial infarction by thrombolytic agents affects several indices characterizing the pathological process. The effect of thrombolytic therapy was studied with reference to the activation of the blood kinin system. The data on a activating effect of myocardial infarction upon the state of the kinin sys tem were proved. When thrombolytic agents (streptoliase, streptase and fibrinolysin) and heparin are given, the kinin system is activated still further which clearly correlates with an elevated fibrinolytic activity of the blood. Under fibrinolytic therapy the most sensitive component of the kinin system proves to be kallikreinogen. The possible effect of the activation of the blood kinin system by thrombolytics upon the state of myocardial infarction patients is discussed.