中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2015年
3期
238-242
,共5页
乙酰肝素酶%促凝%关节置换术
乙酰肝素酶%促凝%關節置換術
을선간소매%촉응%관절치환술
Heparanase%procoagulant%hip and knee-replacement surgery
目的:分析关节置换手术前后血浆乙酰肝素酶水平和活性,探究其与术后循环系统高凝状态的关系。方法:50例膝关节炎行关节置换治疗的患者,在手术前1h、手术后1h、手术后1周、手术后1个月留取血浆,检测乙酰肝素酶水平和促凝活性、组织因子(tissue factor, TF)活性、TF/乙酰肝素酶复合体的活性、Xa因子和凝血酶的水平。结果:乙酰肝素酶在手术后1 h和1周较手术前显著升高(P<0.05);与手术前相比,乙酰肝素酶促凝活性手术后1 h增到(1.29±0.46),手术后1周增加到(2.20±0.74);Xa因子和凝血酶没有显著增加。结论:乙酰肝素酶在关节置换术后1个月内均有较高活性,与关节置换术后高凝状态有关。监测乙酰肝素酶的促凝活性和适当延长低分子肝素抗凝治疗,可减少血栓事件的发生。
目的:分析關節置換手術前後血漿乙酰肝素酶水平和活性,探究其與術後循環繫統高凝狀態的關繫。方法:50例膝關節炎行關節置換治療的患者,在手術前1h、手術後1h、手術後1週、手術後1箇月留取血漿,檢測乙酰肝素酶水平和促凝活性、組織因子(tissue factor, TF)活性、TF/乙酰肝素酶複閤體的活性、Xa因子和凝血酶的水平。結果:乙酰肝素酶在手術後1 h和1週較手術前顯著升高(P<0.05);與手術前相比,乙酰肝素酶促凝活性手術後1 h增到(1.29±0.46),手術後1週增加到(2.20±0.74);Xa因子和凝血酶沒有顯著增加。結論:乙酰肝素酶在關節置換術後1箇月內均有較高活性,與關節置換術後高凝狀態有關。鑑測乙酰肝素酶的促凝活性和適噹延長低分子肝素抗凝治療,可減少血栓事件的髮生。
목적:분석관절치환수술전후혈장을선간소매수평화활성,탐구기여술후순배계통고응상태적관계。방법:50례슬관절염행관절치환치료적환자,재수술전1h、수술후1h、수술후1주、수술후1개월류취혈장,검측을선간소매수평화촉응활성、조직인자(tissue factor, TF)활성、TF/을선간소매복합체적활성、Xa인자화응혈매적수평。결과:을선간소매재수술후1 h화1주교수술전현저승고(P<0.05);여수술전상비,을선간소매촉응활성수술후1 h증도(1.29±0.46),수술후1주증가도(2.20±0.74);Xa인자화응혈매몰유현저증가。결론:을선간소매재관절치환술후1개월내균유교고활성,여관절치환술후고응상태유관。감측을선간소매적촉응활성화괄당연장저분자간소항응치료,가감소혈전사건적발생。
Objective To analyze the plasma heparanase level and activity in patients before and after hip and knee-replacement surgery and to evaluate the relationship with postoperative hypercoagulable state. Methods Plasma samples in 50 patients with knee osteoarthritis under knee-replacement surgery were col?lected preoperatively and at one hour, one week and one month postoperation. Samples were tested for heparan?ase levels, heparanase procoagulant activity, tissue factor activity, tissue factor/heparanase complex activity, fac?tor Xa and thrombin levels. Results Heparanase levels were significantly higher one hour and one week post-operatively compared to pre-operative levels (P<0.05). The most dramatic changes were observed in hepa?ranase procoagulant activity, which reached 1.29 ± 0.46 one hour postoperatively and 2.20 ± 0.74 one week after surgery. Levels of factor Xa and thrombin were not significantly changed. Conclusion Heparanase pro-coagu?lant activity increases one week postoperatively and remains high one month after operation. Extending prophylactic anticoagulant therapy or evaluating hepa? <br> ranase procoagulant activity may potentially prevent late thrombotic events.