Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montréal, QC, Canada.
J Thromb Haemost. 2011 Mar;9(3):481-8. doi: 10.1111/j.1538-7836.2010.04164.x.
Recurrent deep vein thrombosis (DVT) risk factors include a first idiopathic DVT, strongly suggesting the existence of undiagnosed and/or unidentified prothrombotic abnormalities.
To evaluate the impact of locally increased red blood cell (RBC) aggregation on DVT pathogenesis in a rabbit model.
DVT presence, flow and aggregation were measured in situ with ultrasound. Greatly enhanced aggregation was achieved by covalent linkage of Pluronic F98 to the RBC surface; coating with Pluronic F68, which very mildly enhances aggregation, was used as a coating control. On day 1, endothelial damage and a partial stenosis were surgically created on the left femoral vein whereas the right femoral vein was not manipulated.
A thrombus was formed within 30 min in six out of seven left femoral veins of animals receiving a 30% volume blood exchange with F98-coated RBC, whereas a thrombus occurred in only one out of seven veins in F68-transfused controls. In vivo imaging using quantitative ultrasound confirmed increased aggregation in the thrombosed veins of the F98 group compared with the F68 group and the contralateral vessel. For each group, five animals were followed for 2 weeks before being killed. In F98-transfused animals, lysis of clots occurred and the presence of chronic thrombi totally occluding the vein in three out of five animals was confirmed by histology. Conversely, in the F68 group, a single disorganized blood clot was observed in one out of five animals.
A marked increase in RBC aggregation promotes thrombosis in rabbit femoral veins, confirming a pathophysiological role of locally altered hemorheology in the onset of DVT.
复发性深静脉血栓形成（DVT）的危险因素包括首次特发性 DVT，强烈提示存在未诊断和/或未识别的促血栓形成异常。
在兔模型中评估局部红细胞（RBC）聚集增加对 DVT 发病机制的影响。
通过超声原位测量 DVT 的存在、血流和聚集。通过 Pluronic F98 与 RBC 表面的共价键合极大地增强了聚集；使用 Pluronic F68 作为涂层对照，它仅轻度增强聚集。在第 1 天，通过手术在左股静脉上造成内皮损伤和部分狭窄，而右股静脉未进行操作。
在接受 30%体积用 F98 涂层 RBC 进行血液交换的七只动物的左股静脉中，有六只在 30 分钟内形成了血栓，而在接受 F68 输注的对照动物中，只有一只在七只静脉中形成了血栓。使用定量超声进行的体内成像证实，与 F68 组和对侧血管相比，F98 组血栓形成的静脉中聚集增加。对于每组，五只动物在被杀死之前被随访 2 周。在 F98 转输动物中，血栓溶解，组织学证实三分之五的动物中有慢性血栓完全阻塞静脉。相反，在 F68 组中，五分之一的动物中只观察到一个不规整的血凝块。
RBC 聚集的显著增加促进了兔股静脉的血栓形成，证实了局部血液流变学改变在 DVT 发病机制中的病理生理作用。
