Trappe A, Hafter R, Wendt P, Graeff H, Blümel G
Neurochirurgia (Stuttg). 1986 May;29(3):78-82. doi: 10.1055/s-2008-1053707.
Various biochemical processes in hematoma fluid arising from chronic subdural bleeding have not yet been clearly explained. We examined the question whether formation of hematoma fluid after onset of bleeding is preceded by complete clotting with fibrin formation and subsequent lysis of the clot. 22 samples of hematoma fluid taken during operation were used. The protein content was 5.7 +/- 9.8 g/l (mean +/- SD), and coagulable fibrinogen could not be demonstrated whereas 0.99 +/- 0.45 mg/ml fibrin(ogen) break-down products were found immunologically. The high levels of crosslinked D-D fibrin derivatives (0.32 +/- 0.26 mg/ml) were conspicuous: there was a correspondingly high degree of crosslinking (86.2% x/- 12.2%) of the fibrin(ogen) break-down products (calculated from the proportion of dimeric to monomeric gamma-chains). Monoclonal antibodies specific for D-D were employed for the first time to answer the question. The characterization of the crosslinked fibrin derivatives together with their submolecular sub-units and the quantification of the D-D content serve to prove that fibrin is both formed and broken down in chronic subdural hematomas.
慢性硬膜下出血产生的血肿液中的各种生化过程尚未得到明确解释。我们研究了出血开始后血肿液的形成是否先有纤维蛋白形成的完全凝血，随后是凝块溶解的问题。使用了手术期间采集的22份血肿液样本。蛋白质含量为5.7±9.8g/l（平均值±标准差），未检测到可凝固的纤维蛋白原，而通过免疫方法检测到纤维蛋白（原）降解产物为0.99±0.45mg/ml。交联D - D纤维蛋白衍生物的高水平（0.32±0.26mg/ml）引人注目：纤维蛋白（原）降解产物有相应高程度的交联（86.2%±12.2%）（根据二聚体与单体γ链的比例计算）。首次使用针对D - D的单克隆抗体来回答这个问题。交联纤维蛋白衍生物及其亚分子亚基的表征以及D - D含量的定量有助于证明慢性硬膜下血肿中纤维蛋白既形成又分解。
