极低出生体重儿组织因子和组织因子途径抑制剂的协同释放。

Coordinated release of tissue factor and tissue factor pathway inhibitor in VLBW infants.

机构信息

Children's Hospital, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland.

出版信息

Acta Paediatr. 2013 Jun;102(6):584-9. doi: 10.1111/apa.12220. Epub 2013 Mar 25.

DOI:10.1111/apa.12220

PMID:23458419

Abstract

AIM

Tissue factor (TF), a mediator between coagulation and inflammation, is upregulated in alveolar compartment and circulation in very low birthweight (VLBW) infants. We investigated the contribution of TF to systemic regulation of coagulation in VLBW infants.

METHODS

We measured TF, total and free tissue factor pathway inhibitor (TFPIt, TFPIf), prothrombin fragment (F1 + 2), and thrombin-antithrombin complexes (TAT) in plasma from 51 VLBW infants during their first week of life.

RESULTS

F1 + 2 in cord plasma was high (1385 pmol/mL) and decreased postnatally to 17% (p = 0.002). TAT decreased from a high cord concentration to 3% postnatally (p < 0.001). Plasma TF increased and peaked on day 3, showing no correlation with F1 + 2 or TAT. TFPIt and TFPIf increased postnatally, correlating with TF (day 1 TFPIf: R = 0.595, p < 0.001, day 3 TFPIf: R = 0.582, p < 0.001). Based on the TF/TFPIf ratio, a relative excess of plasma TF over TFPIf probably prevailed on day 3.

CONCLUSIONS

In VLBW infants plasma TF fails to associate with thrombin formation. This is partly explained by release of TFPI. Despite TFPI, the newborn VLBW infant is subjected to a substantial circulating pool of TF with potential proinflammatory effects.

摘要

目的

组织因子（TF）是凝血和炎症之间的介质，在极低出生体重（VLBW）婴儿的肺泡腔和循环中上调。我们研究了 TF 对 VLBW 婴儿全身凝血调节的贡献。

方法

我们测量了 51 名 VLBW 婴儿出生后第一周血浆中的 TF、总组织因子途径抑制剂（TFPIt、TFPIf）、凝血酶原片段（F1+2）和凝血酶-抗凝血酶复合物（TAT）。

结果

脐带血浆中的 F1+2 较高（1385 pmol/mL），出生后下降至 17%（p=0.002）。TAT 从脐带高浓度下降至 3%出生后（p<0.001）。血浆 TF 增加并在第 3 天达到峰值，与 F1+2 或 TAT 无关。TFPIt 和 TFPIf 出生后增加，与 TF 相关（第 1 天 TFPIf：R=0.595，p<0.001，第 3 天 TFPIf：R=0.582，p<0.001）。根据 TF/TFPIf 比值，第 3 天可能存在相对过量的血浆 TF 超过 TFPIf。