Lisowski Piotr, Małyszko Jolanta, Jackowsk Ryszard, Myśliwiec Michał, Lisowska Anna, Łapiński Tomasz, Pawlak Krystyna, Hirnle Tomasz
Department of Cardiac Surgery, Medical Academy, Białystok, Poland.
Kardiol Pol. 2004 Feb;60(2):112-22.
Atherogenesis is triggered by functional or structural endothelial injury which leads to humoral and secretion alterations. The haemostatic system plays a significant role in the development of atherosclerosis and its complications, especially acute coronary syndromes.
To assess the effects of coronary artery by-pass grafting (CABG) on some haemostatic factors in patients with stable coronary artery disease (CAD).
The study group consisted of 45 patients (11 females, 34 males, mean age 60.4+/-9.4 years, range 35-75 years). Endothelial function marker - von Willebrand factor (vWF), and thrombin generation parameters - thrombin-antithrombin complexes (TAT) and prothrombin fragments - F1+2 were measured before as well as 3 days, 7 days and 3 months after CABG. The control group consisted of 33 healthy volunteers (17 females, 16 males, mean age 48.8+/-17.2 years).
Serum concentration of vWF as well as TAT and F1+2 levels were significantly higher in the CABG group than in controls. Compared with baseline values, the vWF levels were significantly higher 3 and 7 days after CABG.
There is a hypercoagulability state in patients with CAD who undergo CABG. The use of extracorporeal circulation causes a significant increase in the vWF level which suggests a marked endothelial injury caused by CABG procedure.
动脉粥样硬化的发生是由功能性或结构性内皮损伤引发的,这会导致体液和分泌的改变。止血系统在动脉粥样硬化及其并发症(尤其是急性冠状动脉综合征)的发展过程中起着重要作用。
评估冠状动脉旁路移植术(CABG)对稳定型冠状动脉疾病(CAD)患者某些止血因子的影响。
研究组由45例患者组成(11例女性,34例男性,平均年龄60.4±9.4岁,范围35 - 75岁)。在CABG术前以及术后3天、7天和3个月测量内皮功能标志物 - 血管性血友病因子(vWF),以及凝血酶生成参数 - 凝血酶 - 抗凝血酶复合物(TAT)和凝血酶原片段 - F1 + 2。对照组由33名健康志愿者组成(17例女性,16例男性,平均年龄48.8±17.2岁)。
CABG组的vWF血清浓度以及TAT和F1 + 2水平显著高于对照组。与基线值相比,CABG术后3天和7天vWF水平显著升高。
接受CABG的CAD患者存在高凝状态。体外循环的使用导致vWF水平显著升高,这表明CABG手术引起了明显的内皮损伤。