Henriksson A E, Nilsson T K, Svensson J O
Department of Surgery, Sundsvall County Hospital, Sweden.
Blood Coagul Fibrinolysis. 1993 Dec;4(6):877-80.
One hundred consecutive patients with acute upper gastrointestinal bleeding were investigated. Blood coagulation and fibrinolytic activity were monitored by levels of plasma thrombin-antithrombin III (TAT) complex and plasmin-alpha 2-antiplasmin (PAP) complex in samples obtained from patients at admission with haematemesis and/or melana and in samples obtained from patients the first day after admission. Blood was transfused according to a restrictive policy. Median plasma TAT complex was significantly elevated both at admission and on the first day after admission compared with a reference group. Plasma PAP complex levels were normal at admission but decreased on the first day after admission. This decrease was independent of blood transfusion. The results indicate hypercoagulability at admission among patients with upper gastrointestinal haemorrhage reinforced by the development of a hypofibrinolytic state during the first day after admission. Restricted blood transfusion was not associated with any detectable change in blood coagulation or fibrinolysis in these patients.
对100例连续性急性上消化道出血患者进行了研究。通过测定呕血和/或黑便患者入院时以及入院后第一天所采集样本中的血浆凝血酶 - 抗凝血酶III（TAT）复合物和纤溶酶 - α2 - 抗纤溶酶（PAP）复合物水平，来监测凝血和纤溶活性。输血遵循限制性策略。与参照组相比，入院时和入院后第一天的血浆TAT复合物中位数均显著升高。血浆PAP复合物水平入院时正常，但入院后第一天下降。这种下降与输血无关。结果表明，上消化道出血患者入院时存在高凝状态，且在入院后第一天因纤溶状态减退而加重。在这些患者中，限制性输血与凝血或纤溶方面的任何可检测到的变化均无关联。
