Amrani D L, Christensen C, Hauerwas L, Rieder M, Mosesson M W, Schmidt D, Flemma R, Prophet G A, Pierce W
Department of Health Sciences, University of Wisconsin-Milwaukee.
ASAIO Trans. 1991 Jul-Sep;37(3):M308-10.
The authors evaluated the potential for thrombotic complications arising from implantation of a ventricular assist device (Sarns/3M-VAD) in four calves. Coagulation screening tests (prothrombin time [PT], partial thromboplastin time [PTT], thrombin time [TT]), fibrinogen levels, and antithrombin III functional activity were found to be of little value as predictors of the degree of activation of the hemostatic system. However, platelet counts, adenosine diphosphate (ADP)- and collagen-induced platelet aggregation, and thromboxane (TXB2) levels were good indicators of changes in platelet reactivity. Platelet counts (initial value 6 x 10(5) rose, and were associated with increased rate and extent of ADP- and collagen-induced platelet aggregation, which remained elevated during the entire 25 day postimplantation period. The first 5 days postimplantation revealed a typical acute inflammatory response, with increased platelet levels, but with TXB2 levels significantly decreased during this period. A monoclonal antibody based bovine D-dimer assay and Western blot studies indicated a small but significant increase in circulating bovine D-dimer, indicating localized fibrin formation and its dissolution.
作者评估了在四头小牛中植入心室辅助装置（Sarns/3M-VAD）引发血栓并发症的可能性。凝血筛查试验（凝血酶原时间[PT]、部分凝血活酶时间[PTT]、凝血酶时间[TT]）、纤维蛋白原水平和抗凝血酶III功能活性被发现作为止血系统激活程度的预测指标价值不大。然而，血小板计数、二磷酸腺苷（ADP）和胶原诱导的血小板聚集以及血栓素（TXB2）水平是血小板反应性变化的良好指标。血小板计数（初始值6×10⁵）上升，并与ADP和胶原诱导的血小板聚集速率和程度增加相关，在植入后的整个25天期间一直保持升高。植入后的前5天显示出典型的急性炎症反应，血小板水平升高，但在此期间TXB2水平显著下降。基于单克隆抗体的牛D-二聚体检测和蛋白质印迹研究表明，循环牛D-二聚体有小幅但显著的增加，表明局部纤维蛋白形成及其溶解。
