Division of Cardiovascular and Diabetes Research, Section on Mechanisms of Thrombosis, Leeds Institute for Genetics, Health and Therapeutics, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, United Kingdom.
Arterioscler Thromb Vasc Biol. 2011 Dec;31(12):3004-10. doi: 10.1161/ATVBAHA.111.236786. Epub 2011 Sep 15.
Abdominal aortic aneurysm (AAA) is characterized by widening of the aorta. Once the aneurysm exceeds 5.5 cm, there is a 10% risk of death due to rupture. AAA is also associated with mortality due to other cardiovascular disease. Our aim was to investigate clot structure in AAA and its relationship to aneurysm size.
Plasma was obtained from 49 controls, 40 patients with small AAA, and 42 patients with large AAA. Clot formation was studied by turbidity, fibrin pore structure by permeation, and time to half lysis by turbidity with tissue plasminogen activator. Plasma clot pore size showed a stepwise reduction from controls to small to large AAA. Lag phase for plasma clot formation and time to half lysis were prolonged, with smaller AAA samples showing intermediate response. Clot structure was normal in clots made with fibrinogen purified from patients compared with controls, suggesting a role for other plasma factors. Endogenous thrombin potential and turbidity using tissue factor indicated that the effects were independent of changes in thrombin generation.
Patients with AAA form denser, smaller pored plasma clots that are more resistant to fibrinolysis, and these characteristics correlate with aneurysm size. Clot structure may play a role in AAA development and concomitant cardiovascular disease.
腹主动脉瘤（AAA）的特征是主动脉扩张。一旦动脉瘤超过 5.5 厘米，破裂导致死亡的风险为 10%。AAA 还与其他心血管疾病导致的死亡率相关。我们的目的是研究 AAA 中的血栓结构及其与动脉瘤大小的关系。
从 49 名对照者、40 名小 AAA 患者和 42 名大 AAA 患者中获得血浆。通过浊度法研究血栓形成，通过渗透法研究纤维蛋白孔结构，通过浊度法和组织纤溶酶原激活物研究半溶解时间。血浆血栓孔大小显示从对照者到小 AAA 到大 AAA 呈逐步减小。血浆血栓形成的迟滞期和半溶解时间延长，小 AAA 样本表现出中间反应。与对照者相比，从患者中纯化的纤维蛋白原制成的血栓中，血栓结构正常，提示其他血浆因子的作用。组织因子的内源性凝血酶潜能和浊度表明，这些影响独立于凝血酶生成的变化。
AAA 患者形成更致密、孔更小的血浆血栓，对纤维蛋白溶解的抵抗力更强，这些特征与动脉瘤大小相关。血栓结构可能在 AAA 的发展和伴随的心血管疾病中发挥作用。
