Increased PA-inhibitor levels in the postoperative period--no cause-effect relation with increased cortisol.
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 less than 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 1/2, 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.
M F
MF
Aillaud
I
I
Juhan-Vague
M C
MC
Alessi
M
M
Marecal
M F
MF
Vinson
C
C
Arnaud
P
P
Vague
D
D
Collen
D000005:Abdomen / Q000601:surgery*; D000209:Acute-Phase Proteins; D000328:Adult; D000368:Aged; D001780:Blood Coagulation Tests; D001798:Blood Proteins / Q000096:biosynthesis; D006023:Glycoproteins / Q000096:biosynthesis / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis / Q000097:blood*; D008875:Middle Aged; D010960:Plasminogen Activators / Q000037:antagonists & inhibitors*; D015849:Plasminogen Inactivators; D011184:Postoperative Period; D013997:Time Factors
D000209:Acute-Phase Proteins; D001798:Blood Proteins; D006023:Glycoproteins; D015849:Plasminogen Inactivators; D010960:Plasminogen Activators; D006854:Hydrocortisone