Posttraumatic changes in plasma free plasminogen activator inhibitor-1 in patients with multiple trauma and severe burn.
スポンサーリンク
概要
- 論文の詳細を見る
To clarify the changes which occur postinjury in intravascular fibrinolysis, plasma levels of tissue-type plasminogen activator (t-PA) antigen, total plasminogen activator inhibitor 1 (PAI-1), and the t-PA-PAI-1 complex were measured by enzyme immunoassay, and free PAI-1 and free t-PA were calculated in this study. Blood samples were taken at 12, 24, 48, 72, 120, and 168hr postinjury in ten patients who had sustained multiple traumatic injuries with hemorrhagic shock (ISS: 25-48) and in five patients who had severe burns with hypovolemic shock (SBA: 32-67%, Burn Index: 21-46). Two patients died, one of multiple organ failure on the tenth day after burn injury and one on the thirtieth day after multiple trauma. The results were as follows; a) There was a significant correlation between total PAI-1 antigen and free PAI-1 antigen (r=0.992, p<0.0001). Thus, it is likely that an increase in total PAI-1 antigen reflects an increase in PAI-1 activity. b) The plasma t-PA and free PAI-1 levels increased in the immediate postinjury period, the increase in the latter markedly exceeding that in the former. c) The free t-PA, the ratio of the concentrations of the PAI-1·t-PA complex to free PAI-1, was decreased throughout the course, suggesting posttraumatic hypofibrinolysis. d) The plasma levels of antithrombin III and lactate, and the ratio of TAT to PIC, correlated significantly with free PAT-1. e) The ratio of AT III to free PAI-1 correlated significantly with clinical outcome. The results of this study indicate that posttraumatic hypofibrinolysis caused by increased synthesis of PAI-1 may enhance posttraumatic hypercoagulability, and thus may lead to organ damage. Therefore, the concentration of the free PAI-1 antigen or the ratio of AT III to free PAI-1 are potentially useful indices for predicting prognosis.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
- Emergency Endovascular Repair for a Ruptured Abdominal Aortic Aneurysm Patient
- Degree of injury severity of the traffic accident autopsy cases.
- タイトル無し
- The Effect of Antithrombin III on Cytokine Production in Endotoxemic Rats.
- Antithrombin III Effects on the Production of Vasoactive Substances in Endotoxemic Rats.