Influence of operative trauma on F XII and Inhibitor of plasminogen activator

U Hedner, D Bergqvist
1981 Thrombosis and Haemostasis  
A parallel decrease of factor XII and an inhibitor of plasminogen activator (PA inhibitor) earlier described by Hedner (1973, 1980) was observed in a small series of patients postoperatively (Hedner 1978). In order to further investigate this, 52 patients (29 males and 23 females) were studied in connection with vascular surgery. The following parameters were analysed: factor XII (clotting and imm.chem.assays), PA inhibitor, α2-antiplasmin (α2AP), α2-macroglobulin (α2M) and CT-inactivator
more » ... A)(rocket technique) and factor IX (clotting assay). A significant parallel decrease to about 50 % of factor XII measured with both methods reaching its minimum on day 4-5 postop as well as of the PA inhib was seen. This decrease was found in all patient groups except those operated upon because of varicose veins. These latter patients all left the hospital already on the 2nd or 3rd postop day. No concomitant decrease of α2AP, α2M, CT-INA was seen. The observed lowering of f XII and PA inhib on day 4-5 did not depend on changes in haematocrit associated with the operation.The findings of a parallel decrease of f XII and the PA inhib shown to inhibit f Xlla (Hedner and Martinsson 1978) may indicate that an activation of f XII followed by consumption of this factor as well as of the inhibitor to f Xlla occurs during or after surgery. Whether the f XII dependent fibrinolysis is of importance in the defence against deep venous thrombosis is still debatable. It is, however, striking that low levels of f XIIa occurs postop at a time when most proteins show an increased synthesis rate because of stimulation by the acute phase reaction. Furthermore inhibitors against the activation phase is known to be associated with thrombotic disease (Hedner and Nilsson 1976).
doi:10.1055/s-0038-1652758 fatcat:zshpidkgqfgijjrsxzr7gwedcm