Spoerke Nicholas, Underwood Samantha, Differding Jerome, Van Phil, Sambasivan Chitra, Shapiro David, Schreiber Martin
Division of Trauma and Critical Care, Oregon Health and Science University, Portland, Oregon, USA.
J Trauma. 2010 May;68(5):1106-11. doi: 10.1097/TA.0b013e3181d86860.
Ethanol intoxication is a common contributor to traumatic injury. It is unknown whether ethanol consumption contributes to the coagulation differences seen between men and women after trauma. Our aim was to examine the combined effect of ethanol intoxication and gender on coagulation.
Fifty-eight healthy subjects participated and chose to enter into a control group (CG; n = 20; 10 men and 10 women) or drinking group (DG; n = 38; 20 men and 18 women). Venous blood samples for thrombelastography, plasminogen activator inhibitor, thrombin-antithrombin complex, and tissue plasminogen activator were drawn at the beginning of the study. Subjects then interacted in a social atmosphere for at least 2 hours, eating and consuming alcoholic (DG) or nonalcoholic (CG) beverages. After 2 hours, blood alcohol level was determined and blood was drawn for a second set of coagulation studies.
Demographics were similar between groups except for age (36.7 years CG vs. 29.9 years DG; p = 0.009). All baseline thrombelastography measurements were similar between the CG and DG. Blood alcohol levels in the DG were similar between genders at the end of study. At the end of study, a decreased rate of fibrin formation, decreased clot strength, and a decreased rate of fibrin cross-linking was seen in men but not in women. Fibrinolysis was inhibited in drinkers compared with controls.
Consumption of commonly ingested quantities of alcohol correlated with the development of a hypocoagulable state in men but had no effect on coagulation status in women. This phenomenon may contribute to differences in post-trauma coagulation status previously noted between genders.
乙醇中毒是创伤性损伤的常见诱因。乙醇摄入是否会导致创伤后男女凝血差异尚不清楚。我们的目的是研究乙醇中毒和性别对凝血的联合影响。
58名健康受试者参与研究，他们选择进入对照组（CG；n = 20；10名男性和10名女性）或饮酒组（DG；n = 38；20名男性和18名女性）。在研究开始时采集静脉血样本，用于血栓弹力图、纤溶酶原激活物抑制剂、凝血酶 - 抗凝血酶复合物和组织纤溶酶原激活物检测。然后，受试者在社交环境中互动至少2小时，进食并饮用含酒精（DG）或不含酒精（CG）的饮料。2小时后，测定血液酒精水平，并抽取血液进行第二轮凝血研究。
除年龄外（CG组36.7岁，DG组29.9岁；p = 0.009），两组的人口统计学特征相似。CG组和DG组的所有基线血栓弹力图测量结果相似。研究结束时，DG组男女的血液酒精水平相似。研究结束时，男性出现纤维蛋白形成速率降低、血凝块强度降低和纤维蛋白交联速率降低的情况，而女性未出现。与对照组相比，饮酒者的纤维蛋白溶解受到抑制。
摄入通常数量的酒精与男性低凝状态的发展相关，但对女性的凝血状态没有影响。这种现象可能导致先前观察到的男女创伤后凝血状态差异。
