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1.
Perioperative bleeding is associated with postoperative hyperfibrinolysis caused by surgical trauma in the setting of total hip and knee arthroplasty (THA/ TKA). The study aimed to clarify the dynamics of postoperative fibrinolytic activity and the values of fibrin degeneration products and thromboelastography (TEG) to guide precisive antifibrinolytic therapy.Forty three patients undergoing primary unilateral THAs and 40 TKAs were included to the prospective observational cohort study. Venous blood sample at different time points (preoperative, intraoperative, postoperative 6 hours, 12 hours, 24 hours, 48 hours) were drawn to test D-dimer, fibrin (-ogen) degradation products (FDP) and TEG.The TEG parameters associated with coagulation (R, K, α, MA, and CI) and fibrinolysis (estimate percent lysis and Ly30) were all in normal range although had a higher level than preoperative time (P < .05). The postoperative levels of D-dimer and FDP were higher than preoperative level (P < .05). The dynamics of D-dimer and FDP presented a bimodal pattern, which peaked at 6 hours postoperatively, then remained and decreased until 24 hours, but would rebound at 48 hours postoperatively with smaller amplitude. Moreover, FDP6h (P = .028), D-Dimer6h (P = .044), FDP12h (P = .009), D-dimer12h (P = .007), and FDP48h (P = .016) were all correlated with total blood loss on POD3.FDP and D-dimer were effective and practical markers for prediction of acute postoperative fibrinolytic activity, which peaked at 6 hours after end of surgery and would maintain for at least 24 hours.  相似文献   
2.
Osteogenesis imperfecta (OI) is characterized by susceptibility to bone fractures. Other symptoms, such as easy bruising and bleeding complications during surgery necessitating transfusions, have also been reported. The aim of the cross-sectional pilot study was to assess the bleeding and bruising tendency in OI patients and to screen for possible underlying haematological disorders. Bleeding tendency was investigated using the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT) in 22 adult OI patients. Laboratory testing was performed to investigate for bleeding disorders or abnormal coagulation. Four patients [OI type 1(n = 3), OI type 4(n = 1)] had a bleeding score (BS) fitting with a bleeding tendency, but without test results pointing to a coagulopathy. Two patients [OI type 1(n = 1), OI type 3 (n = 1)] without a bleeding tendency according to the BS had increased fibrinolysis. This is the second largest study to date addressing bleeding tendency in OI and the first study to use ISTH-BAT and elaborate laboratory testing for coagulopathies. Four patients had an increased bleeding tendency. However, laboratory testing demonstrated no bleeding disorder or abnormal coagulation. Increased fibrinolysis was demonstrated in two patients without bleeding tendency on BS. Vascular fragility as a cause of bleeding tendency in OI has been suggested earlier. Further research on bleeding tendency in OI is important.  相似文献   
3.
【摘要】目的 探讨吲达帕胺联合厄贝沙坦对高血压并发充血性心力衰竭(CHF)患者的疗效及凝血 纤溶系统的影响。方法 纳入2018年10月~2019年10月我院86例高血压并发CHF患者将其随机分为对照组和观察组,每组各43例。对照组给予厄贝沙坦治疗,观察组基于以上加予吲达帕胺片治疗。对比两组治疗前及治疗3个月后的血压水平和心功能情况,评估两组临床疗效,比较治疗前及治疗3个月后的血小板标志物和血浆凝血 纤溶系统指标水平。结果 治疗3个月,两组患者的收缩压(SBP)、舒张压(DBP)、左心室舒张期内径(LVEDD)、左室收缩末期内径(LVESD)值较治疗前显著降低(P<005),左室射血分数(LVEF)值较治疗前显著增加(P<005),观察组显著高于对照组(P<005);观察组的临床总有效率显著高于对照组(P<005);治疗3个月,两组患者的血小板糖蛋白Ⅱb/Ⅲa受体(PAC 1)、P 选择素(CD62P)水平相比治疗前有显著降低(P<005),两组患者的血浆D D、纤维蛋白原(FIB)、纤溶酶原激活抑制物 1(PAI 1)水平相比治疗前有显著降低,血浆组织型纤溶酶原激活物(t PA)相比治疗前有显著升高(均P<005),以上指标观察组的变化幅度显著大于对照组(P<005)。 结论 吲达帕胺片联合厄贝沙坦治疗能提高高血压并发CHF患者的临床疗效,有效改善患者的血压水平和心功能,且对血小板PAC 1、CD62P有明显抑制作用,并改善凝血 纤溶系统指标。  相似文献   
4.
目的:基于网络药理学分析土鳖虫对破血逐瘀相关疾病的作用机制。方法:经文献查阅并结合PubChem、SwissADME、SwissTargetPrediction和TCMSP等数据库对土鳖虫已知成分及其对应靶点进行搜集,并与经GeneCards、OMIM、TTD、HPO数据库搜索得到的“破血逐瘀”相关靶点进行交互分析得到共同靶点;通过蛋白-蛋白质-蛋白质相互作用(PPI)分析、基因本体(GO)分析和京都基因与基因组百科全书(KEGG)分析,构建土鳖虫“成分-靶点-疾病”网络,探讨土鳖虫破血逐瘀功效的作用机制。同时采用体外纤溶实验评价土鳖虫水溶性蛋白质与其他成分的活性差异。结果:筛选得到土鳖虫活性化合物54个,共对应靶点653个;与血瘀相关的17种疾病的16141个作用靶点经交互分析得出两者共有靶点26个。GO和KEGG分析结果表明,土鳖虫已知成分主要涉及嘌呤代谢通路、细胞能量代谢通路、环磷酸鸟苷(cGMP)信号通路、Toll样受体信号通路、醛固酮合成代谢通路、三酰甘油合成通路等13条信号通路,通过干预DNA转录、细胞能量代谢等生物功能发挥药效。同时体外纤溶实验得出土鳖虫水溶性蛋白质较其他成分表现出更强的纤溶活性。结论:土鳖虫已知活性成分并不能很好的证明其对破血逐瘀相关疾病的治疗有显著的效果。结合土鳖虫水溶性蛋白质促纤溶作用,为下一步土鳖虫纤溶物质基础的研究提供参考。  相似文献   
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6.
This study investigated the effect of testosterone deficiency and replacement on platelets function and aggregation, coagulation, and fibrinolysis in young adult healthy male rats. Rats were classified into three groups (n = 6/group) of either “a sham-operated+ vehicle,” “an orchidectomized (ORX)+ vehicle,” and “an ORX+testosterone propionate (0.5 mg/kg, 3X/week, S.C).” All treatments were carried out for 12 weeks. Our results showed that ORX rats had induced platelets aggregation and coagulation and inhibited fibrinolysis. ORX-induced rats had increased ratios of adenosine diphosphate-induced aggregation, shorter bleeding time, clotting time, prothrombin time, and activated partial thromboplastin time and their sera showed increased levels of thromboxane B2 and fibrinogen levels. Concomitantly, their plasma showed increased TPA-1 and decreased tissue plasminogen activator (tPA) levels. At molecular levels, the aorta of ORX-induced rats showed increased aortic mRNA and protein levels of plasminogen activator inhibitor-1 (PAI-1), protein levels of von Willebrand Factor (vWF) and decreased mRNA and protein levels of tPA, and their liver showed increased protein levels of prothrombin and factor VII. Testosterone post-therapy to ORX-induced rats significantly reversed all these hematological and molecular changes. In conclusion, independent of any other risk factors, testosterone deficiency induces platelets aggregation and hypercoagulation and inhibits fibrinolysis, effects that can be reversed by testosterone therapy.  相似文献   
7.
Prosthetic heart valve (PHV) dysfunction is a rare but serious complication whose optimal management may be challenging and requires a multidisciplinary approach. Treatment success ultimately depends on determining the underlying mechanism of valve dysfunction by echocardiography. However, being able to establish the main etiology is not always straightforward. We present a difficult case of obstructive PHV dysfunction and discuss clinical and echocardiographic parameters to help differentiate thrombus from pannus formation.  相似文献   
8.
目的:探讨microRNA-340(miR-340)对施万细胞纤溶能力的调控作用及作用的靶基因。方法:采用溶圈实验来检测miR-340对施万细胞纤溶能力的影响,用荧光素酶双报告基因系统确定miR-340与组织型纤溶酶原激活剂的靶向关系,用实时定量聚合酶链反应检测坐骨神经夹伤后组织型纤溶酶原激活剂mRNA和miR-340的表达变化。结果:miR-340能够抑制施万细胞的纤溶能力,并直接靶向作用于组织型纤溶酶原激活剂的3’UTR,坐骨神经夹伤后组织型纤溶酶原激活剂mRNA与miR-340的表达呈负相关性。结论:miR-340通过直接靶向组织型纤溶酶原激活剂的3’UTR,从而下调靶基因组织型纤溶酶原激活剂的表达抑制施万细胞的纤溶能力。  相似文献   
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