The releasing ability of vascularplasminogen activator (VA) from vessel wall is considered to be a key to the development of thrombosis and its prognosis.
Applying the venous occlusion (VO) test by Nilson and Pandolfi as an index of the decrease in VA or difficulty in VA release, the author was clinically established VO test method measuring the euglobulin clot lysis time (ELT) before and after venous occlusion for 10 minutes under intermediate pressure between diastolic and systolic pressures. Clinically, the VO test was used in collagen disease. The following results were obtained.
1. In normal adult, ELT measured before and after venous occlusion, there was no difference in terms of age or sex.
2. Coagulation and fibrinolytic factors measured before and after the VO test were observed within the normal range.
3. In active SLE cases within 5 years after the onset, it was recognized that VA at rest and in venous occlusion were increased. In both active and inactive SLE cases at more than 10 years from the onset, VA at rest and VA in venous occlusion were decreased. With SLE cases in the comparatively early stage, there was increased VA release due to vasculitis, while in SLE cases passed about 10 years exhaustion and unreleasing of VA were noticed.
4. In progressive systemic sclerosis, the fibrinolytic activity was increased. In the Behçet cases, however, fibrinolytic activity was decreased and VA release was exhausted. In rheumatoid arthritis cases, findings suggested impaired VA release.
5. It could be established that the author's clinically and fundamental analysis on VO test could well serve as an important index for the fibrinolytic activity of thrombogenesis and the key to the development and prognosis of thrombosis.