腹主动脉瘤破裂所致休克患者的凝血激活。
Activated coagulation in patients with shock due to ruptured abdominal aortic aneurysm.
作者信息
Skagius E, Siegbahn A, Bergqvist D, Henriksson A
机构信息
Department of Surgery, Sundsvall County Hospital, Sweden.
出版信息
Eur J Vasc Endovasc Surg. 2008 Jan;35(1):37-40. doi: 10.1016/j.ejvs.2007.07.023. Epub 2007 Oct 24.
BACKGROUND
Ruptured abdominal aortic aneurysm is associated with a high operative mortality. Postoperative thrombosis related complications are common, a possible mechanism being activation of the coagulation system and endothelial stimulation. The aim of the present study was to investigate the coagulation activity preoperatively in patients with ruptured and nonruptured abdominal aortic aneurysm in relation to the clinical outcome with special regard to the influence of shock.
METHODS
Ninety-five patients with repair of infrarenal aortic aneurysm and forty-one controls without aneurysm matched by age, gender and smoking habits were studied. Thrombin-antithrombin (TAT), prothrombin fragment 1+2 (F 1+2), and von Willebrand factor antigen (vWFAg) were measured.
RESULTS
There were significantly higher levels of TAT, F 1+2, and vWFAg in patients operated for ruptured compared to nonruptured abdominal aortic aneurysm. The highest level of TAT and F 1+2 were detected in patients with rupture and shock.
CONCLUSION
The present data indicate a state of activated coagulation in patients with ruptured abdominal aortic aneurysm which is reinforced by shock.
背景
腹主动脉瘤破裂与手术死亡率高相关。术后血栓形成相关并发症很常见，一种可能的机制是凝血系统激活和内皮刺激。本研究的目的是调查破裂性和非破裂性腹主动脉瘤患者术前的凝血活性，以及与临床结局的关系，特别关注休克的影响。
方法
研究了95例接受肾下腹主动脉瘤修复的患者和41例无动脉瘤的对照者，后者按年龄、性别和吸烟习惯进行匹配。检测了凝血酶-抗凝血酶（TAT）、凝血酶原片段1+2（F 1+2）和血管性血友病因子抗原（vWFAg）。
结果
与非破裂性腹主动脉瘤患者相比，接受破裂性腹主动脉瘤手术的患者TAT、F 1+2和vWFAg水平显著更高。在破裂且伴有休克的患者中检测到最高水平的TAT和F 1+2。
结论
目前的数据表明，破裂性腹主动脉瘤患者存在凝血激活状态，休克会加剧这种状态。
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