γ' 纤维蛋白原水平与创伤性脑损伤患者的血栓强度有关。
γ' fibrinogen levels are associated with blood clot strength in traumatic brain injury patients.
机构信息
Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
出版信息
Am J Surg. 2020 Aug;220(2):459-463. doi: 10.1016/j.amjsurg.2019.12.028. Epub 2019 Dec 28.
BACKGROUND
γ' fibrinogen is an alternatively-spliced fibrinogen variant that displays different coagulation parameters in vitro than the major form of fibrinogen. Purified γ' fibrinogen has slower clotting kinetics than unfractionated fibrinogen, but forms clots that are stronger and resistant to fibrinolysis. However, these properties have only been investigated in human populations in a limited number of studies. We therefore performed a retrospective analysis to test the hypothesis that γ' fibrinogen levels influence coagulation in vivo.
METHODS
In the present study, we utilized blood samples that were collected from traumatic brain injury patients to probe the relationship between γ' fibrinogen levels and traditional coagulation parameters.
RESULTS
The results show that the levels of γ' fibrinogen were inversely associated with clotting kinetics, indicated by a shortened INR. In addition, the levels of γ' fibrinogen were associated with stronger clots by thrombelastography. However, these changes were not associated with significant changes in hemorrhage progression.
CONCLUSIONS
These findings verify that γ' fibrinogen properties observed in purified systems result in similar properties in a clinical setting, and may affect coagulation.
背景
γ'纤维蛋白原是一种替代拼接的纤维蛋白原变体，其在体外的凝血参数与主要形式的纤维蛋白原不同。与未分级的纤维蛋白原相比，纯化的γ'纤维蛋白原具有较慢的凝固动力学，但形成的凝块更强，抗纤维蛋白溶解。然而，这些特性仅在少数研究中在人类群体中进行了调查。因此，我们进行了一项回顾性分析，以检验γ'纤维蛋白原水平影响体内凝血的假设。
方法
在本研究中，我们利用从创伤性脑损伤患者采集的血液样本，探究γ'纤维蛋白原水平与传统凝血参数之间的关系。
结果
结果表明，γ'纤维蛋白原水平与凝血动力学呈负相关，INR 缩短。此外，血栓弹性描记术显示 γ'纤维蛋白原水平与更强的血栓有关。然而，这些变化与出血进展无明显相关性。
结论
这些发现验证了在纯化系统中观察到的γ'纤维蛋白原特性在临床环境中产生类似的特性，并可能影响凝血。
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