纤溶酶原激活物抑制物1及4G/5G多态性与术后深静脉血栓的关系

目的:探讨血浆纤溶酶原激活物抑制物1(PAI 1)水平在手术前、后的改变,分析PAI 1水平改变及 其基因4G/5G多态性与手术后深静脉血栓(DVT)形成的关系。方法:发色底物法检测24例正常对照和29例 行中等手术治疗患者术前、术后24h、术后72h血浆PAI 1活性,运用聚合酶链反应(PCR)技术检测各研究个体 的基因型。结果:(1)PAI 1活性与甘油三酯之间有显著相关性(r=0.583;P<0.01);(2)PAI 1活性在手术后 24h,72h较术前有增高的趋势,但差异无统计学意义;(3)各不同基因型患者之间手术前后PAI 1活性变化差异 无显著性。结论:(1)手术后患者机体纤溶功能受到一定程度的抑制;(2)PAI 1及其基因4G/5G多态性在行中 型手术治疗患者中,不能作为手术后DVT形成的高危预测因素。手术后DVT的形成可能与手术的类型、大小、 部位以及手术后长期卧床等其它高危因素有关。

A Study on the Relationship of Plasminogen Inhibitor-1(PAI-1)and Its Polymorphisms of 4G/5G in Promoter Region with Deep Venous Thrombosis after Operation

Objective: To measure the change of PAI-1 activity in pre- and post-operation, and to explore the possible relationship between the change of PAI-1 activity and its gene 4G/5G Polymorphism and deep venous thrombosis after operation. Method: PAI-1 activity was examined in 24 healthy people (as control) and 29 patients undergoing moderate operation before and 24 and 72 hours after operation. PAI-1 genotypes of all cases were detected by polymerase chain reaction (PCR). Results: 1) Triglycerides was significantly associated with PAI-1 activity (r=0.583,P=0.001). 2) PAI-1 activity was elevated in 24, 72 hours after operation compared with that before operation, but the difference was not significant. 3) The changes of PAI-1 activity during operation in different genotypes were not significantly different. Conclusions: 1) The fibrinolysis of patients undergoing moderate operation was inhibited after operation to some degree. 2) PAI-1 and its 4G/5G polymorphism can not be a predictor of deep venous thrombosis after moderate operation. The occurrence of deep venous thrombosis after operation might be correlated with the operative type, operation size and place, and other risk factors.