Schobersberger Wolfgang, Mittermayr Markus, Fries Dietmar, Innerhofer Petra, Klingler Anton, Faulhaber Martin, Gunga Hanns-Christian, Streif Werner
Institute for Leisure, Travel and Alpine Medicine, University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, A-6060 Hall/Tyrol, Austria.
Thromb Res. 2007;119(3):293-300. doi: 10.1016/j.thromres.2006.03.003. Epub 2006 Apr 21.
Long-haul flights are associated with an increased incidence for venous thromboembolic events. At present, markers of coagulation and fibrinolysis were only analyzed from arm veins after long distance travel. Respective data from leg veins are missing.
Here, we measured these parameters in healthy volunteers (n=12) before and after 10 h sitting in modern aircraft chairs under normobaric hypoxia (corresponding to 2400 m altitude). Blood was collected from arm and leg veins before, immediately after and 1 day after sitting in the hypoxic chamber.
We did not find any evidence for a significant intravasal thrombin and fibrin formation and a changed fibrinolytic activity, neither in arm nor in leg vein blood. TAT, PAP, and PAI-1 remained unchanged, and the increases of F1+2 in arm veins and of d-dimer in leg veins were within the upper reference limits. Moreover, there was no evidence of activation of coagulation as measured by thrombelastography (ROTEM(R)) and the new Thrombin Dynamic Test at both locations. There was no evidence of arm or leg hemoconcentration.
In healthy volunteers, prolonged sitting in ergonomically superior aircraft seats does not induce significant changes in blood coagulation and fibrinolysis in venous blood of arm or leg. Since this study was performed under moderate hypoxia, reduction in oxygen pressure seems not to be a crucial factor for venous thrombosis at long-haul flights.
长途飞行与静脉血栓栓塞事件的发生率增加有关。目前，长途旅行后仅从手臂静脉分析凝血和纤维蛋白溶解标志物。缺少来自腿部静脉的相应数据。
在此，我们在正常低氧（相当于海拔2400米）条件下，对12名健康志愿者在现代飞机座椅上坐10小时前后的这些参数进行了测量。在进入低氧舱前、就座后即刻以及就座后1天，从手臂和腿部静脉采集血液。
我们未发现手臂或腿部静脉血中有显著的血管内凝血酶和纤维蛋白形成以及纤维蛋白溶解活性改变的证据。凝血酶 - 抗凝血酶复合物（TAT）、纤溶酶 - 抗纤溶酶复合物（PAP）和纤溶酶原激活物抑制剂 -1（PAI -1）保持不变，手臂静脉中F1 + 2以及腿部静脉中D - 二聚体的升高均在参考上限范围内。此外，通过血栓弹力图（ROTEM(R)）和新的凝血酶动态试验在两个部位测量均未发现凝血激活的证据。没有手臂或腿部血液浓缩的证据。
在健康志愿者中，长时间坐在符合人体工程学的飞机座椅上不会导致手臂或腿部静脉血中的凝血和纤维蛋白溶解发生显著变化。由于本研究是在中度低氧条件下进行的，氧分压降低似乎不是长途飞行中静脉血栓形成的关键因素。
