Sue-Ling H M, Johnston D, Verheijen J H, Kluft C, Philips P R, Davies J A
Br J Surg. 1987 Apr;74(4):275-8. doi: 10.1002/bjs.1800740416.
Euglobulin lysis time (ELT), tissue plasminogen activator (tPA), and the fast-acting inhibitor of tPA, were measured pre-operatively in 128 patients who underwent elective major abdominal surgery. Deep venous thrombosis (DVT) was detected by 125I-labelled fibrinogen scan in 37 patients (29 per cent) after operation. Pre-operatively, there was diminished euglobulin lysis activity (332 +/- 197 versus 255 +/- 156 min, mean +/- s.d.; P less than 0.025), and tissue plasminogen activator activity (4.2 +/- 9.9 versus 7.7 +/- 14.3 milliunits/ml, mean +/- s.d.; P = 0.094) in patients who subsequently developed postoperative DVT compared with those who did not. There was no significant difference between the two groups in the level of inhibition of tissue plasminogen activator (160.6 +/- 75.4 per cent versus 152.5 +/- 77.5 per cent, mean +/- s.d.; n = 47). Stepwise logistic discriminant analysis of the data obtained preoperatively showed that tissue plasminogen activator, a more specific measure of fibrinolytic activity, was a weaker predictor of DVT than euglobulin lysis time. The results confirm other observations which indicate that lowered fibrinolytic activity is a risk factor for postoperative DVT. In addition, they suggest that this is not due entirely to low levels of activity of tissue plasminogen activator in plasma.
对128例行择期腹部大手术的患者，术前测定其优球蛋白溶解时间（ELT）、组织型纤溶酶原激活剂（tPA）以及tPA的快速作用抑制剂。术后通过125I标记的纤维蛋白原扫描在37例患者（29%）中检测到深静脉血栓形成（DVT）。术前，与未发生术后DVT的患者相比，发生术后DVT的患者优球蛋白溶解活性降低（分别为332±197分钟和255±156分钟，均值±标准差；P<0.025），组织型纤溶酶原激活剂活性降低（分别为4.2±9.9和7.7±14.3毫单位/毫升，均值±标准差；P = 0.094）。两组在组织型纤溶酶原激活剂的抑制水平上无显著差异（分别为160.6±75.4%和152.5±77.5%，均值±标准差；n = 47）。对术前获得的数据进行逐步逻辑判别分析表明，作为纤溶活性更特异指标的组织型纤溶酶原激活剂，预测DVT的能力比优球蛋白溶解时间弱。这些结果证实了其他研究结果，即纤溶活性降低是术后DVT的一个危险因素。此外，这些结果提示这并非完全归因于血浆中组织型纤溶酶原激活剂活性水平低。
