Postoperative Changes in the Plasmatic Levels of Tissue-Type Plasminogen Activator and Its Fast-Acting Inhibitor - Relationship to Deep Vein Thrombosis and Influence of Prophylaxis
Postoperative Changes in the Plasmatic Levels of Tissue-Type Plasminogen Activator and Its Fast-Acting Inhibitor - Relationship to Deep Vein Thrombosis and Influence of Prophylaxis
复制标题
组织型纤溶酶原激活剂及其速效抑制剂血浆水平的术后变化 - 与深静脉血栓形成的关系及预防的影响
作者：
J. Paramo;M. Alfaro;E. Rocha
对60例全髋关节置换术患者的纤维蛋白原、优球蛋白溶解时间（ELT）、组织型纤溶酶原激活物（t-PA）抗原、纤溶酶原激活物抑制剂活性（PA-inhibitor）和α2-抗纤溶酶（a2-AP）进行了术前和术后测定。通过优球蛋白溶解时间延长、t-PA降低、pa抑制剂和β2-AP升高来评估纤溶活性降低。这些变化与125i纤维蛋白原试验诊断的术后深静脉血栓（DVT）无关。然而，术前pa抑制剂活性明显高于术后DVT患者（p <0.01）。阿司匹林（20例）和肝素加二氢麦角胺（20例）的预防性治疗引起了这些参数的显著变化。本研究表明，t-PA的降低和pa抑制剂的升高可能是全髋关节置换术后纤溶活性降低的原因。pa抑制剂水平可能是评估全髋关节置换术患者发生深静脉血栓风险的有用指标。
Summary Fibrinogen, euglobulin lysis time (ELT), tissue-type plasminogen activator (t-PA) antigen, plasminogen activator inhibitor activity (PA-inhibitor) and α2-antiplasmin (a2-AP) were measured pre- and postoperatively in 60 patients undergoing total hip replacement. Reduced fibrinolytic activity as assessed by the prolongation of euglobulin lysis time, decrease of t-PA and increase of PA-inhibitor and β2-AP could be demonstrated. These changes did not correlate with the postoperative deep vein thrombosis (DVT) diagnosed with the 125I-fibrinogen test. However, preoperative PA-inhibitor activity was significantly higher in patients with postoperative DVT (p <0.01). The prophylactic treatment with aspirin (20 patients) and with heparin plus dihy-droergotamine (20 patients) induced significant changes in some of those parameters. This study shows that the decrease of t-PA and the increase of PA-inhibitor may contribute to the reduced postoperative fibrinolytic activity after total hip replacement. PA-inhibitor level might be a useful marker in evaluating the risk of developing DVT in patients undergoing total hip replacement.
阿司匹林在体内抑制血管纤溶酶原激活剂活性。
DOI：
10.1172/jci111454
发表时间：
1984
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Levin,RI;Harpel,PC;Weil,D;Chang,TS;Rifkin,DB
通讯作者：
Rifkin,DB