Thromb Haemost 1985; 54(02): 466-468
DOI: 10.1055/s-0038-1657874
Original Article
Schattauer GmbH Stuttgart

Increased PA-Inhibitor Levels in the Postoperative Period – No Cause-Effect Relation with Increased Cortisol

M F Aillaud
1   The Laboratory of Haematology, Hospital Timone, University of Marseille, France
,
I Juhan-Vague
1   The Laboratory of Haematology, Hospital Timone, University of Marseille, France
,
M C Alessi
1   The Laboratory of Haematology, Hospital Timone, University of Marseille, France
,
M Marecal
1   The Laboratory of Haematology, Hospital Timone, University of Marseille, France
,
M F Vinson
2   The Dept. of Surgery, Hospital Timone, University of Marseille, France
,
C Arnaud
1   The Laboratory of Haematology, Hospital Timone, University of Marseille, France
,
P Vague
3   The Dept. of Diabetology, Hospital Michel Levy, University of Marseille, Marseille, France
,
D Collen
4   The Center of Thrombosis and Vascular Research, University of Leuven, Belgium
› Institutsangaben
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Publikationsverlauf

Received 12. Februar 1985

Accepted 15. Mai 1985

Publikationsdatum:
18. Juli 2018 (online)

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Summary

It has been reported that the level of PA-inhibitor increases in postoperative patients and on the other hand that glucocorticoids increase the PA-inhibitor level in cell culture. Because surgery is associated with increased plasma cortisol level, a relation between the postoperative increase in plasma cortisol and PA-inhibitor levels was looked for.

Blood samples were collected from 8 patients undergoing extensive abdominal surgery, before operation and postoperatively at 2 hr, 4 hr, 24 hr and daily for 7 days. Plasma cortisol and PA-inhibitor were increased 2 hr after surgery, when there was a significant correlation (p <0.05). The maximum increase was at 24 hr and the values fell to normal on day 6. An increase in t-PA related antigen (t-PA R:Ag) and a decrease in euglobulin fibrinolytic activity (EFA) also occurred.

In 7 controls 0.25 mg ACTH was given intravenously and blood was collected after ½, 1, 2, 4, 6 hr. Although the increase in plasma cortisol level following ACTH was comparable to that observed after surgery the increase was not associated with significant change in PA-inhibitor level, t-PA R: Ag or EFA.

A cause-effect relationship between the increased plasma cortisol and PA-inhibitor level could not be shown. The mechanism of the postoperative increase in PA-inhibitor thus remains unknown.