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创伤后纤溶系统的激活在严重钝性创伤的大鼠模型中迅速而强烈地受到抑制。

Fibrinolytic system activation immediately following trauma was quickly and intensely suppressed in a rat model of severe blunt trauma.

机构信息

Department of Emergency Medicine, Hokkaido University Hospital, N14W5, Kita-ku, Sapporo, 060-8648, Japan.

出版信息

Sci Rep. 2021 Oct 13;11(1):20283. doi: 10.1038/s41598-021-99426-2.

Abstract

In severe trauma, excessive fibrinolytic activation is associated with an increase in the transfusion volume and mortality rate. However, in the first several hours after a blunt trauma, changes in fibrinolytic activation, suppression, and activation-suppression balance have not yet been elucidated, which the present study aimed to clarify. Anesthetized 9-week-old male Wistar S/T rats experienced severe blunt trauma while being placed inside the Noble-Collip drum. Rats were randomly divided into four groups of seven. The no-trauma group was not exposed to any trauma; the remaining groups were analysed 0, 60, and 180 min after trauma. Immediately following trauma, total tissue-plasminogen activator (tPA) levels significantly increased in the plasma, and the balance of active tPA and active plasminogen activator inhibitor-1 (PAI-1) significantly tipped toward fibrinolytic activation. After trauma, both tPA and PAI-1 levels increased gradually in various organs and active and total PAI-1 levels increased exponentially in the plasma. Total plasma tPA levels 60 min after trauma returned quickly to levels comparable to those in the no-trauma group. In conclusion, fibrinolytic activation was observed only immediately following trauma. Therefore, immediately after trauma, the fibrinolytic system was activated; however, its activation was quickly and intensely suppressed.

摘要

在严重创伤中,过度的纤维蛋白溶解激活与输血量和死亡率的增加有关。然而,在钝性创伤后的最初几个小时内,纤维蛋白溶解激活、抑制和激活-抑制平衡的变化尚未阐明,本研究旨在阐明这一点。麻醉 9 周龄雄性 Wistar S/T 大鼠在 Noble-Collip 鼓内经历严重的钝性创伤。大鼠随机分为四组,每组 7 只。无创伤组不暴露于任何创伤;其余组在创伤后 0、60 和 180 分钟进行分析。创伤后,血浆中总组织型纤溶酶原激活物(tPA)水平显著升高,活性 tPA 和活性纤溶酶原激活物抑制剂-1(PAI-1)的平衡明显向纤维蛋白溶解激活倾斜。创伤后,tPA 和 PAI-1 水平在各种器官中逐渐增加,血浆中活性和总 PAI-1 水平呈指数增加。创伤后 60 分钟时,总血浆 tPA 水平迅速恢复到与无创伤组相当的水平。总之,仅在创伤后立即观察到纤维蛋白溶解激活。因此,创伤后立即激活了纤维蛋白溶解系统;然而,其激活很快且强烈地受到抑制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/503f/8514435/9863fe85dc95/41598_2021_99426_Fig1_HTML.jpg

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