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.
Keywords
PA-inhibitor - Surgery - Cortisol
