Blamey S L, McArdle B M, Burns P, Carter D C, Lowe G D, Forbes C D
Thromb Haemost. 1984 Feb 28;51(1):71-4.
Fibrinolytic shutdown may be important in the development of postoperative deep vein thrombosis (DVT). We have previously shown that stanozolol 50 mg, given intramuscularly 24 hr before surgery, prevents the decrease in plasminogen activator activity (PA) seen on the first postoperative day in patients at high risk of DVT. To investigate the role of fibrinolytic shutdown in causation of DVT, sixty patients were randomized in a double-blind controlled trial to receive stanozolol or placebo intramuscularly, and DVT was detected by leg scanning and confirmed by venography. Scan positive DVT occurred in 11 of 31 placebo patients (35%) and 12 of 29 who received stanozolol (41%). A significant decrease in PA was confirmed in the placebo group, while stanozolol caused a significant increase in PA on the first postoperative day. Patients in either group who did not develop DVT showed minimal changes in PA. We conclude that prevention of fibrinolytic shutdown by this regimen of stanozolol does not prevent postoperative DVT, and that further studies are required to clarify the relationship of postoperative fibrinolysis and DVT.
纤维蛋白溶解功能关闭可能在术后深静脉血栓形成（DVT）的发生中起重要作用。我们之前已经表明，在手术前24小时肌肉注射50毫克司坦唑醇，可防止DVT高危患者术后第一天出现的纤溶酶原激活物活性（PA）降低。为了研究纤维蛋白溶解功能关闭在DVT病因中的作用，60名患者在一项双盲对照试验中被随机分组，肌肉注射司坦唑醇或安慰剂，通过腿部扫描检测DVT，并通过静脉造影进行确认。31名安慰剂组患者中有11名（35%）扫描显示阳性DVT，29名接受司坦唑醇治疗的患者中有12名（41%）扫描显示阳性DVT。安慰剂组PA显著降低，而司坦唑醇在术后第一天使PA显著升高。两组中未发生DVT的患者PA变化最小。我们得出结论，这种司坦唑醇治疗方案预防纤维蛋白溶解功能关闭并不能预防术后DVT，需要进一步研究以阐明术后纤维蛋白溶解与DVT之间的关系。
