In order to evaluate precisely the fibrinolytic state in clinical disorders, plasma levels of fibrinogenolysis products (FgDP), fibrinolysis products (FbDP) and fibrinogenolysis plus fibrinolysis products (TDP) were measured by newly developed sandwich ELISA in patients with hematological malignancies, diabetes mellitus, thrombotic disease, liver disease and disseminated intravascular coagulation (DIC). The mean plasma levels of FgDP, FbDP and TDP in 27 healthy subjects were 389±SD 127, 246±98 and 685±205ng/ml, respectively. Not only FbDP but also FgDP were elevated in a variety of diseases except for liver disease and diabetes. Marked elevations in both FbDP and FgDP were found in DIC followed by hematological malignancies and thrombotic disease. Among several disease categories underlying DIC, patients with acute promyelocytic leukemia and vascular disease had a high FgDP/TDP ratio and patients with sepsis had the lowest. On the whole, FgDP and FbDP values were positively correlated with plasmin-α2-plasmin inhibitor complex and thrombin-antithrombin III complex, and negatively correlated with α2-plasmin inhibitor. These findings indicate that primary fibrinogenolysis is rare in liver disease, but fibrinolysis is usually accompanied by fibrinogenolysis in DIC, thrombotic disease and hematological malignancies. Thus measurements of FgDP, FbDP and TDP would be valuable for the precise assessment of fibrinolysis in selected disease states.
