title: Tissue plasminogen activator and plasminogen activator inhibitor-1 levels in patients with acute paraquat intoxication.
abstract: To investigate the effects of reactive oxygen species (ROS) on tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) plasma levels, and their possible implications on clinical outcome, we measured tPA and PAI-1 levels in 101 patients with acute paraquat (PQ) intoxication. The control group consisted of patients who ingested non-PQ pesticides during the same period. tPA and PAI-1 levels were higher in the PQ group than in the controls. PQ levels were significantly correlated with ingested amount, timelag to hospital, tPA level, and hospitalization duration. tPA levels were correlated with PAI-1, fibrin degradation product (FDP), and D-dimer. D-dimer levels were lower in the PQ group than in the controls. Univariate analysis indicated the following significant determinants of death: age, ingested amount, PQ level, timelag to hospital, serum creatinine, lipase, pH, pCO(2), HCO(3) (-), WBC, FDP, PAI-1, and tPA. However, multivariate analysis indicated that only PQ level was significant independent factor predicting death. In conclusion, tPA and PAI-1 levels were higher, while D-dimer levels were lower in the PQ group than in the controls, implying that ROS stimulate tPA and PAI-1, but PAI-1 activity overrides tPA activity in this setting. Decreased fibrinolytic activity appears to be one of the clinical characteristics of acute PQ intoxication.
authors.affiliation: Department of Internal Medicine, College of Medicine, Soonchunhyang University, Cheonan, Korea.
authors.forename: Su-Jin
authors.initials: SJ
authors.lastname: Seok
authors.forename: Su-Ji
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hyo-Wook
authors.initials: HW
authors.lastname: Gil
authors.forename: Jong-Oh
authors.initials: JO
authors.lastname: Yang
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Lee
authors.forename: Sae-Yong
authors.initials: SY
authors.lastname: Hong
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006540:Herbicides / Q000097:blood / Q000506:poisoning*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000097:blood / Q000506:poisoning*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D017382:Reactive Oxygen Species / Q000378:metabolism; D012307:Risk Factors; D010959:Tissue Plasminogen Activator / Q000097:blood*; D014057:Tomography, X-Ray Computed
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D006540:Herbicides; D017395:Plasminogen Activator Inhibitor 1; D017382:Reactive Oxygen Species; C036309:fibrin fragment D; D010959:Tissue Plasminogen Activator; D010269:Paraquat