The changes of coagulation and fibrinolysis system in acute lung injury/acute respiratory distress syndrome
YE Ling, JIN Mei-ling△, BAI Chun-xue ,XU Xiao-bo, GAO Lei, ZHU Lei
Author information+
Department of Respiration，ZhongShan Hospital，Fudan University, Shanghai 200032, China
{{custom_zuoZheDiZhi}}
{{custom_authorNodes}}
{{custom_bio.content}}
{{custom_bio.content}}
{{custom_authorNodes}}
Collapse
History+
Received
Revised
Published
2008-02-29
1900-01-01
2008-09-20
Issue Date
2008-09-20
Abstract
Objective To explore the influence of acute lung injury/acute respiratory distress syndrome (ALI/ARDS) on coagulation and fibronolysis system by examining the plasma levels of protein C (PC), thrombomodulin (TM), plasminogen activator inhibitor-1 (PAI-1). Methods The study was divided into two groups: ALI/ARDS patients (n=24) and normal volunteers (n=12). The plasma levels of PC antigen, TM antigen and PAI-1 antigen were determined by enzyme-linked immunosorbent assay (ELISA). The plasma level of active PC (APC) was determined by chromogenic substrate method. Furthermore, ALI/ARDS patients were estimated with APACHE II score and multiple organ dysfunction syndrome (MODS) score. ALI/ARDS patients were studied by dividing patients into subsets based on the numbers of organ dysfunction and prognosis. Results The plasma levels of APC and PC antigen were significantly lower in patients with ALI/ARDS than those of the normal controls (P<0.05); the levels of TM antigen and PAI-1 antigen were significantly higher in ALI/ARDS patients than those in the normal controls (P<0.01). Furthermore, there was a significant negative correlation between the plasma level of APC in patients and APACHE II score and MODS score (P<0.01); a positive correlation between the level of PAI-1 antigen and APACHE II score (P<0.01), MODS score (P<0.05). However, there was no correlation between the levels of PC antigen, TM antigen and APACHE II score, MODS score. The plasma level of APC in patients with single lung dysfunction was significantly higher than that in patients with MODS (P<0.01); however, there was no difference in the levels of PC antigen, TM antigen and PAI-1 antigen between patients with single lung dysfunction and patients with MODS. The plasma levels of APC, PC antigen,TM antigen and PAI-1 antigen in patients who survived did not differ from those in patients who died. Conclusions The results suggest that there is an increased procoagulant activity and reduced fibrinolytic activity in patients with ALI/ARDS. Furthermore, there is a correlation between the extent of change in the coagulation and fibronolysis system and the seriousness of ALI/ARDS.
YE Ling;JIN Mei-ling△;BAI Chun-xue;XU Xiao-bo;GAO Lei;ZHU Lei.
The changes of coagulation and fibrinolysis system in acute lung injury/acute respiratory distress syndrome[J]. Fudan University Journal of Medical Sciences, 2008, 35(5): 671-0
PDF(533 KB)
