Department of Laboratory Diagnostics and Molecular Medicine, Pomeranian Medical University, Szczecin, Poland.
J Physiol Pharmacol. 2013 Jun;64(3):321-30.
Many circulating haemostatic markers have been investigated in relation to the abdominal aortic aneurysm (AAA) size, growth as well as intraluminal thrombus (ILT) size. However, the results of these studies seem to be uncertain and inconsistent. The first aim of the present study was to compare the haemostatic parameters of fibrinolysis and some of thrombotic markers in patients with AAA and controls. We also examined the relationship between those parameters and both maximum aneurysm diameter and intraluminal thrombus thickness. Tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI-1), fibrinogen (Fb), D-dimer, prothrombin fragments 1 and 2 (F1+2), thromboxane B2 (TXB2) and lipids profile were measured in 36 patients with AAA and 30 controls. The mean maximum aortic diameter in patients with the AAA was 59±12 mm (range 42-100). The mean ILT thickness was 32±10 mm (range 8-56). Among haemostatic factors, t-PA and D-dimer levels, but not PAI-1, were significantly higher in subjects with the AAA. There was a strong positive correlation between thickness of intraluminal thrombus and maximum aneurysm size (r=0.69, p<0.0001), and the negative relationship between t-PA and ILT thickness (r= -0.53, p=0.001) as well as aneurysm diameter (r= -0.38, p=0.023). Higher plasma concentrations of t-PA and D-dimer support the hypothesis that the secondary fibrinolysis plays an important role in the pathogenesis of the aortic abdominal aneurysm formation. In addition, the negative correlation between t-PA plasma level and ILT thickness suggests that thrombotic/fibrinolysis imbalance may favour accelerated formation of intraluminal thrombus and possibly aneurysm progression.
许多与腹主动脉瘤（AAA）大小、生长以及管腔内血栓（ILT）大小相关的循环止血标志物已被研究。然而，这些研究的结果似乎不确定且不一致。本研究的首要目的是比较 AAA 患者和对照组的纤溶和一些血栓形成标志物的止血参数。我们还检查了这些参数与最大动脉瘤直径和管腔内血栓厚度之间的关系。组织型纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制剂（PAI-1）、纤维蛋白原（Fb）、D-二聚体、凝血酶原片段 1 和 2（F1+2）、血栓烷 B2（TXB2）和血脂谱在 36 名 AAA 患者和 30 名对照组中进行了测量。AAA 患者的平均最大主动脉直径为 59±12mm（范围 42-100）。平均 ILT 厚度为 32±10mm（范围 8-56）。在止血因子中，t-PA 和 D-二聚体水平，但不是 PAI-1，在 AAA 患者中明显升高。管腔内血栓厚度与最大动脉瘤大小之间存在强烈的正相关（r=0.69，p<0.0001），t-PA 与 ILT 厚度之间呈负相关（r=-0.53，p=0.001）以及动脉瘤直径（r=-0.38，p=0.023）。较高的 t-PA 和 D-二聚体血浆浓度支持继发性纤溶在腹主动脉瘤形成的发病机制中起重要作用的假说。此外，t-PA 血浆水平与 ILT 厚度之间的负相关表明血栓形成/纤溶失衡可能有利于管腔内血栓形成的加速和可能的动脉瘤进展。
