Melissari E, Scully M F, Paes T, Ellis V, Kakkar V V
Thromb Haemost. 1986 Feb 28;55(1):54-7.
The response of components of the coagulation and fibrinolysis systems to infusion of DDAVP has been examined in patients undergoing elective surgery. In the DDAVP treated group there was a significant increase, compared to control, in plasminogen activator (by fibrin plates p less than 0.005, ECLT p less than 0.0125, by Student's t test) before operation. No difference between groups was seen by either methods in the activator levels in samples 24 h postoperation, whereas a significant drop (p less than 0.002) in protein C concentration was observed at this stage in the treated group. Levels of factor VIII components were significantly higher (p less than 0.005) than control at all stages of operation and a significant shortening (5 sec p less than 0.05) of the APTT was seen at all stages (apart from 24 h samples). DDAVP infusion therefore may exacerbate the hypercoagulable state observed in surgical patients without preventing the (post-operatively) fibrinolytic shutdown. Instead, infusion tends to produce fibrinolytic depletion at the key mid-operative stage.
在接受择期手术的患者中，研究了凝血和纤溶系统各成分对去氨加压素输注的反应。与对照组相比，去氨加压素治疗组在手术前纤溶酶原激活剂显著增加（通过纤维蛋白平板法p<0.005，发色底物法p<0.0125，学生t检验）。术后24小时样本中的激活剂水平，两组用任何一种方法均未观察到差异，而在此阶段治疗组中观察到蛋白C浓度显著下降（p<0.002）。在手术的所有阶段，VIII因子成分水平均显著高于对照组（p<0.005），并且在所有阶段（除24小时样本外）均观察到活化部分凝血活酶时间显著缩短（5秒，p<0.05）。因此，去氨加压素输注可能会加剧手术患者中观察到的高凝状态，而不会阻止（术后）纤溶关闭。相反，输注倾向于在关键的手术中期产生纤溶消耗。
