Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass

KOCAK, Hikmet; ÜNLÜ, Yahya; TEKİN, Salim B.

Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass

Yahya ÜNLÜ, (Atatürk Üniversitesi, Tıp Fakültesi, Göğüs Kalp Damar Cerrahisi Anabilim Dalı, Erzurum, Türkiye)

Salim B. TEKİN, (Atatürk Üniversitesi, Tıp Fakültesi, Hematoloji Anabilim Dalı, Erzurum, Türkiye)

Hikmet KOÇAK (Atatürk Üniversitesi, Tıp Fakültesi, Göğüs Kalp Damar Cerrahisi Anabilim Dalı, Erzurum, Türkiye)

Turkish Journal of Medical Sciences

1 0

Yıl: 2007 Cilt: 37 Sayı: 6 Sayfa Aralığı: 345 - 350 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass

Öz:

Amaç: Kardiyopulmoner bypass (KPB) esnasında kanın yabancı yüzeylerle teması, koagulasyon sisteminin aktive olmasına yol açar. Bu çalışmanın amacı KPB öncesinde, esnasında ve sonrasında protein C (PC) ve protein S (PS), doku plazminojen aktivatörü (t-PA) ve fibrinojen (F) düzeylerini değerlendirmektir. Yöntem ve gereç: Bu çalışmaya elektif koroner arter bypass cerrahisi (KABC) yapılan 33 hasta ve kardiyak cerrahi yapılmayan 11 hasta (kontrol grubu) alındı. Kan örnekleri ameliyat öncesi, KPB öncesi, esnası ve sonrasında ve ameliyat sonrası olmak üzere farklı zamanlarda alındı. KPB öncesinde, esnasında ve sonrasında PC ve PS, t-PA ve F düzeyleri ölçüldü. Bulgular: KPB esnasında PC ve PS ve F düzeyleri azaldı (p < 0.05). Bir hiperfibrinolizis markeri olan t-PA düzeyleri, KPB esnasında daha yüksekti. Bu durum KABC ile birlikte subklinik hemostatik aktivasyonun geliştiğini gösterebilir. KPB başlangıcında aorttaki kros klemp kaldırılmadan önce t-PA düzeyi 8 kat arttı, KPB esnasında ve ameliyat sonrası erken dönemde ise yüksek kaldı. KPB süresince PC ve PS ve F düzeyleri azaldı ve bu düşüş KPB’ın sonuna kadar devam etti. Kontrol grubunda hemostatik markerler arasında anlamlı bir fark yoktu. Tüm parametreler için gruplar arasında anestezi indüksiyonundan önce ve KPB esnasında istatistiki olarak önemli fark vardı (p< 0.01). Sonuç: Bir hiperfibrinolizis markeri olan t-PA düzeyleri, KPB esnasında yüksekti ve ameliyat sonrası erken dönemde de yüksek kaldı. Protein C ve PS ve F düzeyleri KPB süresince azaldı. Bu sonuçlar trombin generasyonunun KPB esnasında arttığını göstermektedir.

Anahtar Kelime:

Konular: Cerrahi

Kardiyopulmoner bypass esnasında protein-c ve protein-s, doku plazminojen aktivatörü ve fibrinojen düzeyleri

Öz:

The exposure of blood to foreign surfaces during cardiopulmonary bypass (CPB) leads to an activation of the coagulation system. The goal of this study was to evaluate the levels of protein C and protein S, tissue- plasminogen activator (t-PA) and fibrinogen before, during and after CPB. Materials and Methods: Thirty-three patients undergoing elective coronary artery bypass grafting (CABG) and 11 patients undergoing non-cardiac surgery (control group) were included in this study. Blood samples were taken at different time intervals preoperatively, before, during and after CPB, and in the postoperative period. Protein C and protein S, t-PA and fibrinogen levels were measured before, during and after CPB. Results: Protein C, protein S and fibrinogen levels were decreased during CPB (p<0.05). As a marker of hyperfibrinolysis, levels of t-PA were higher during CPB, which might suggest ongoing subclinical hemostatic activation associated with CABG. Before release of aortic cross clamp, t-PA level had increased eight-fold. t- PA levels remained elevated throughout CPB and into the early postoperative period. Protein C, protein S and fibrinogen levels remained decreased throughout CPB, and the decrease continued until the end of CPB. There was no difference in the hemostatic markers in the control group. There was a statistically significant difference between the groups (p<0.01) before the induction of anesthesia and during CPB for all parameters (p<0.01).Conclusions: As a marker of hyperfibrinolysis, levels of t-PA were increased during CPB and remained elevated in the early postoperative period. Protein C, protein S and fibrinogen levels were decreased during CPB. These results showed that thrombin generation is increased during CPB.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÜNLÜ Y, TEKİN S, KOCAK H (2007). Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. , 345 - 350.
Chicago	ÜNLÜ Yahya,TEKİN Salim B.,KOCAK Hikmet Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. (2007): 345 - 350.
MLA	ÜNLÜ Yahya,TEKİN Salim B.,KOCAK Hikmet Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. , 2007, ss.345 - 350.
AMA	ÜNLÜ Y,TEKİN S,KOCAK H Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. . 2007; 345 - 350.
Vancouver	ÜNLÜ Y,TEKİN S,KOCAK H Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. . 2007; 345 - 350.
IEEE	ÜNLÜ Y,TEKİN S,KOCAK H "Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass." , ss.345 - 350, 2007.
ISNAD	ÜNLÜ, Yahya vd. "Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass". (2007), 345-350.

APA	ÜNLÜ Y, TEKİN S, KOCAK H (2007). Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. Turkish Journal of Medical Sciences, 37(6), 345 - 350.
Chicago	ÜNLÜ Yahya,TEKİN Salim B.,KOCAK Hikmet Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. Turkish Journal of Medical Sciences 37, no.6 (2007): 345 - 350.
MLA	ÜNLÜ Yahya,TEKİN Salim B.,KOCAK Hikmet Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. Turkish Journal of Medical Sciences, vol.37, no.6, 2007, ss.345 - 350.
AMA	ÜNLÜ Y,TEKİN S,KOCAK H Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. Turkish Journal of Medical Sciences. 2007; 37(6): 345 - 350.
Vancouver	ÜNLÜ Y,TEKİN S,KOCAK H Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass. Turkish Journal of Medical Sciences. 2007; 37(6): 345 - 350.
IEEE	ÜNLÜ Y,TEKİN S,KOCAK H "Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass." Turkish Journal of Medical Sciences, 37, ss.345 - 350, 2007.
ISNAD	ÜNLÜ, Yahya vd. "Levels of protein c and protein s, tissue-plasminogen activator, and fibrinogen during cardiopulmonary bypass". Turkish Journal of Medical Sciences 37/6 (2007), 345-350.