Fellström B, Siegbahn A, Liljenberg G, Haglund O, Wallin R, Tufveson G, Bagge L
Department of Internal Medicine, Uppsala University Hospital, Sweden.
Thromb Res. 1990 Jul 1;59(1):97-104. doi: 10.1016/0049-3848(90)90275-h.
The disturbed coagulation state seen in patients with uremia has been suggested to contribute to thrombotic events in kidney grafts following transplantation. Primary haemostasis, plasmatic coagulation and fibrinolysis were investigated in eight patients before and during four weeks after kidney transplantation. In spite of an improved renal function there was postoperatively still a depressed platelet aggregation and the prostacyclin concentrations in plasma were low. The plasma coagulation seemed to be activated according to short activated partial thromboplastin time, high levels of FVIII:C and prothrombin complex. The fibrinolysis was increased and the PAI-1 levels were decreased. It is concluded that the overall haemostatic balance is characterized by a high degree of activation in uremic patients and that this activation persisted four weeks after transplantation.
尿毒症患者出现的凝血状态紊乱被认为与移植后肾移植中的血栓形成事件有关。对8例患者在肾移植前及移植后四周内的原发性止血、血浆凝血和纤维蛋白溶解情况进行了研究。尽管肾功能有所改善，但术后血小板聚集仍受到抑制，血浆中前列环素浓度较低。根据活化部分凝血活酶时间缩短、FVIII:C和凝血酶原复合物水平升高，血浆凝血似乎被激活。纤维蛋白溶解增加，PAI-1水平降低。得出的结论是，尿毒症患者的整体止血平衡的特点是高度活化，且这种活化在移植后四周仍持续存在。
