Eriksson B I, Eriksson E, Gyzander E, Teger-Nilsson A C, Risberg B
Department of Orthopedics, Ostra Hospital, Gothenburg, Sweden.
Acta Orthop Scand. 1989 Apr;60(2):159-63. doi: 10.3109/17453678909149244.
Twenty-nine patients were operated on with the Charnley hip prosthesis. All the patients were given dextran 70 as thrombosis prophylaxis. Deep vein thrombosis (DVT) was diagnosed in 10 patients with the radioactive fibrinogen uptake test and phlebography. Variables of coagulation and fibrinolysis were studied before and after surgery. Tissue plasminogen activator (t-PA) activity in the plasma without venous occlusion decreased postoperatively, but there was no correlation with DVT. The t-PA activity in venous occlusion plasma was not reduced after surgery. Plasminogen activator inhibitor (PAI-1) levels were raised immediately postoperatively. There was a significant correlation between preoperative PAI-1 activity and development of postoperative DVT (P less than 0.05). Patients developing DVT had higher levels of PAI-1 postoperatively than patients not developing DVT. A defective fibrinolytic system, as defined by high PAI-1 activity, thus predisposed to postoperative DVT.
29例患者接受了Charnley髋关节假体手术。所有患者均接受右旋糖酐70预防血栓形成。通过放射性纤维蛋白原摄取试验和静脉造影诊断出10例深静脉血栓形成（DVT）。对手术前后的凝血和纤溶变量进行了研究。未发生静脉阻塞时血浆中的组织纤溶酶原激活物（t-PA）活性术后降低，但与DVT无相关性。术后静脉阻塞血浆中的t-PA活性未降低。纤溶酶原激活物抑制剂（PAI-1）水平术后立即升高。术前PAI-1活性与术后DVT的发生之间存在显著相关性（P<0.05）。发生DVT的患者术后PAI-1水平高于未发生DVT的患者。因此，由高PAI-1活性定义的纤溶系统缺陷易导致术后DVT。
