心脏手术后的凝血功能障碍可能受功能性纤溶酶原激活物抑制剂基因多态性的影响。
Coagulopathy after cardiac surgery may be influenced by a functional plasminogen activator inhibitor polymorphism.
作者信息
Duggan Edel, O'Dwyer Michael J, Caraher Emma, Diviney Dara, McGovern Eilis, Kelleher Dermot, McManus Ross, Ryan Thomas
机构信息
Department of Anaesthesia, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland.
出版信息
Anesth Analg. 2007 Jun;104(6):1343-7, table of contents. doi: 10.1213/01.ane.0000261267.28891.00.
BACKGROUND
Cytokine-mediated inflammation and coagulopathy may occur after cardiac surgery. In this study we investigated the temporal pattern of plasminogen activator inhibitor-1 (PAI-1) gene expression after cardiac surgery and its relation with PAI genotype, and obtained preliminary data regarding its relation to perioperative morbidity.
METHODS
The relative change in PAI-1 mRNA 1, 6, and 24 h after cardiopulmonary bypass (CPB) was measured from mononuclear cells in 82 patients undergoing elective cardiac surgery. DNA was analyzed for carriage of the 4G/5G PAI-1 polymorphism.
RESULTS
PAI-1 gene expression decreased after CPB in all patients. A larger reduction in PAI-1 gene expression was observed in homozygous carriers of the 5G allele. Homozygous carriers of the 5G allele were also more likely to receive transfusion of coagulation blood products. There was no relation between change in PAI-1 gene expression and duration of CPB.
CONCLUSIONS
PAI-1 gene expression decreased over time after CPB. We found a link between PAI-1 genotype, PAI gene expression, and transfusion of coagulation products after cardiac surgery.
背景
心脏手术后可能会发生细胞因子介导的炎症和凝血病。在本研究中，我们调查了心脏手术后纤溶酶原激活物抑制剂-1（PAI-1）基因表达的时间模式及其与PAI基因型的关系，并获得了有关其与围手术期发病率关系的初步数据。
方法
从82例行择期心脏手术患者的单核细胞中测量体外循环（CPB）后1、6和24小时PAI-1 mRNA的相对变化。分析DNA以检测4G/5G PAI-1多态性的携带情况。
结果
所有患者CPB后PAI-1基因表达均下降。在5G等位基因纯合携带者中观察到PAI-1基因表达有更大程度的降低。5G等位基因纯合携带者也更有可能接受凝血血液制品的输血。PAI-1基因表达的变化与CPB持续时间之间没有关系。
结论
CPB后PAI-1基因表达随时间下降。我们发现了PAI-1基因型、PAI基因表达与心脏手术后凝血制品输血之间的联系。
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