Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Medicine, Chinese Traditional ; adverse effects ; Middle Aged

Adult ; Aged ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Hepatitis B, Chronic ; blood ; Humans ; Male ; Middle Aged ; Prothrombin ; metabolism ; Young Adult

BACKGROUNDAlthough pulmonary embolism (PE) with normal blood D-dimer (DD) concentrations is considered rare, in practice the incidence may be greater than is generally believed. Overlooking PE is potentially dangerous. The aim of this study was to explore the incidence and clinical features of PE with normal DD concentrations.

METHODSWe retrospectively analyzed the records of 29 patients with PE and normal DD concentrations from the past seven years. We here compare relevant clinical characteristics of these patients with those of patients with PE and abnormal DD concentrations. We evaluated the probabilities of differences by computing pretest probability scores (Wells score and revised Geneva score).

RESULTSThe frequency of normal DD concentrations in patients with PE was 4%. Previous episode(s) of PE were more common in patients with normal DD concentrations than in those with abnormal DD concentrations (P = 0.001). Fever, tachycardia, and tachypnea occurred less frequently in the former group (P < 0.05) and time between onset of symptoms and DD testing was longer (P = 0.001). The diagnosis of PE was delayed in 22 of the 29 cases. Nineteen and seven cases with normal DD concentrations were classified according to pretest scores as intermediate and low risk, respectively.

CONCLUSIONSPE with normal DD concentrations is uncommon. Although most diagnoses of PE are ruled out by normal DD values, a small number of cases with PE are missed. A combination of pretest probability score and normal DD concentration increases the probability of making the correct diagnosis, but cannot completely exclude patients with suspected PE. When the clinical manifestations cannot be otherwise explained, clinicians should be alert to the possibility of PE with normal DD concentrations in patients with previous episode(s) of PE or a long interval between onset of symptoms and DD testing.

Aged ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Middle Aged ; Pulmonary Embolism ; blood ; diagnosis ; Retrospective Studies

We measured plasma levels of fibrinogen degradation products (FgDP) with newly developed enzyme-linked immunosorbent assay based on monoclonal antibody to assess the fibrinogenolytic state in 52 patients with various liver diseases (27 patients with liver cirrhosis, 10 with chronic hepatitis, 7 with acute hepatitis, 6 with hepatocellular carcinoma, 2 with intrahepatic cholestasis). As compared with 20 healthy subjects (upper limit: 580 ng/ml), elevated plasma levels (660-32000 ng/ml) of FgDP were found in 19 (36.5%) patients. When analyzed according to the underlying disease categories, the magnitude of elevations of FgDP were most prominent in patients with chronic hepatitis. No correlation was found between plasma FgDP levels and serum AST or ALT activity. These findings indicate that increased primary fibrinogenolysis is not rare in liver disease, but poorly correlates with liver function.
Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Fibrin Fibrinogen Degradation Products/*metabolism ; Fibrinolysis ; Hepatitis/blood ; Human ; Liver Diseases/*blood

The study was aimed to observe the changes of blood coagulation factors in the SD rats suffered from hemorrhagic shock, and to investigate the mechanism of coagulation cascade reaction in the course of shock. The model of hemorrhagic shock was established. 40 SD rats were randomized into eight groups: pre-shock, and 1, 2, 4, 6, 8, 12 and 24 hours after shock, and the levels of plasma FVIII, vWF, TF, D-dimer, FIB, APTT and PT were detected respectively. The result showed that APTT and PT were gradually prolonged, which were significant within 4-6 hour after shock (P < 0.05). APTT and PT were 59.7 seconds and 30.2 seconds respectively. The level of plasma D-dimer markedly increased, and peaked at 8 hour after shock. The level of fibrinogen, TF, vWF and FVIIIa increased in the initial stage of shock. With the development of shock, fibrinogen markedly reduced from 2nd hour (P < 0.05) and dropped to the minimum at 7 hours after shock. Plasma TF, vWF, FVIII significantly decreased after 6 hours and 8 hours (P < 0.001). The ratios of the consumed coagulation factors: FVIII of (86.1 +/- 1.8)%, fibrinogen of (89.6 +/- 0.6)%, vWF (55 +/- 1.4)%, TF (62 +/- 2.5)%. Thus, coagulation factor I (fibrinogen) and FVIII were preferentially consumed. The extrinsic coagulation pathway was dominantly activated, whereas the intrinsic coagulation pathway played a less important role. Fibrinogen and D-dimer might be valuable for the prognosis of patients suffered from shock. It is concluded that hemorrhagic shock trigger the coagulation cascade reaction, and the coagulation factors are greatly consumed. Unbalance of coagulation system plays an important role in the progress of shock.
Animals ; Blood Coagulation ; Blood Coagulation Factors ; metabolism ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinogen ; metabolism ; Male ; Partial Thromboplastin Time ; Prothrombin Time ; Rats ; Rats, Sprague-Dawley ; Shock, Hemorrhagic ; blood

OBJECTIVETo preliminarily explore the relationship between thrombosis and its associated factors in patients with coronary heart disease (CHD) of turbidity-phlegm blocking syndrome (TPB), and to study its acting mechanism.

METHODSPlasma levels of thrombosis-associated factors, including Von Willebrand factor: (vWF), D-dimer, and fibrinogen (Fg), in 85 patients of CHD with TPB, 93 with CHD of non-TPD, and 89 healthy persons were detected and compared.

RESULTSLevels of the three factors were increased in all the CHD: patients, and were higher in TPB patients than in non-TPB patients (P<0.01 or P<0.05).

CONCLUSIONThe TPB: syndrome in CHD patients was closely related to the blood coagulation-fibrinolytic system; they might be in pre-thrombosis state, and the plasma levels of vWF, D-dimer, and Fg could be taken as the objective indices for thrombosis differentiation of TPB syndrome in CHD patients.

Case-Control Studies ; Coronary Disease ; blood ; physiopathology ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinogen ; analysis ; Humans ; Thrombosis ; blood ; physiopathology ; von Willebrand Factor ; metabolism

This study was aimed to investigate the change of tissue factor pathway (TFP) ratio during the attack of acute myocardial infarction (AMI) and its clinical significance. Plasma recalcification time was assayed by manual operation. Plasma tissue factor (TF), TF pathway inhibitor (TFPI) antigen, FVII:Ag, activated FVII (FVIIa) and D-Dimer were measured by enzyme linked immunoabsorbent assay (ELISA). TF activity was determined by chromogenic assay, plasma FVII coagulation activity (FVII:C) was detected by one-stage system. Blood samples were taken from 59 patients with AMI and 84 healthy volunteers. The results indicated that (1) plasma recalcification time was significantly shorter in the AMI group than that in the control; (2) compared with the control, TF activity in AMI patients showed no significant change (p > 0.05); the antigen levels of TF and TFPI in patients with AMI were remarkably increased (p < 0.05), and the increment degree of TF was remarkably higher than that of TFPI, therefore the TF/TFPI ratio was enlarged; total TFPI (t-TFPI) and full-length TFPI (fl-TFPI) were significantly higher (p < 0.01), truncated TFPI (tr-TFPI) was significantly lower (p < 0.01); the TF/t-TFPI ratio was higher than that in normal group, the TF/t-TFPI ratio was lower than that in normal group (p < 0.01), but the TF/tr-TFPI and fl-TFPI/t-TFPI ratios in AMI group were more remarkably higher than that in control group (p < 0.01), the tr-TFPI/t-TFPI and tr-TFPI/fl-TFPI ratios were significantly lower (p < 0.01). (3) compared with the control, the levels of plasma FVIIa and FVII:C in AMI group were higher (p < 0.05), FVII:Ag did not significatly change; FVIIa/FVII: Ag ratio was more remarkably higher (p < 0.01), but the elevation of FVIIa/FVII:C and FVII:C/FVII:Ag ratios showed no significant change (p > 0.05); (4) plasma D-dimer was significantly higher, compared with the normal control (p < 0.01). It is concluded that TFP is initiated during the attack of AMI, suggesting the circulating blood in AMI patients is in hypercoagulable status, therefore the simultaneous detection of multiple coagulation factors is necessary for evaluating risk factors in AMI patients, and the use of ratio for reflecting hypercoagulable status and risk factors is more reliable to detect each of them separately.
Aged ; Blood Coagulation ; Case-Control Studies ; Factor VII ; metabolism ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; blood ; Thromboplastin ; metabolism

OBJECTIVETo evaluate the hemocompatibility of glutaraldehyde (GA)-tanned bovine pericardium additionally treated by sodium bisulfite (SOB) solution.

METHODSThe hemocompatibility of GA-tanned bovine pericardium treated by SOB solution is evaluated by using dynamic clotting time test, blood platelet adhension test, D-dimeride determination, and complement activation test. The GA-tanned bovine pericardium was used as control.

RESULTSThe curve of absorbance-clotting time of two kinds of bovine pericardium was similar in dynamic clotting time test. There was no significant difference between SOB-treated and control groups in blood platelet adhension test. The D-dimeride contents of all bioprostheses were at normal level, and the D-dimeride content of GA-tanned bovine pericardium treated by SOB solution was significantly lower than that of control group (P < 0.05). In complement activation test, the level of complement C3a in SOB-treated group was significantly lower than that in control group (P < 0.05).

CONCLUSIONGA-tanned bovine pericardium treated by SOB solution meets the demands of cardiac interstitial implanted materials in hemocompatibility.

Animals ; Biocompatible Materials ; Bioprosthesis ; Blood Coagulation ; Cattle ; Complement C3a ; analysis ; Fibrin Fibrinogen Degradation Products ; metabolism ; Glutaral ; pharmacology ; Materials Testing ; Pericardium ; drug effects ; metabolism ; Platelet Adhesiveness ; Sulfites ; pharmacology

BACKGROUNDPulmonary embolism (PE) can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken. We aimed to compare the clinical diagnostic values of the Wells score, the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients.

METHODSThree hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (≥65 or <65 years old). The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE, and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard; overall accuracy was evaluated by the area under the curve (AUC) of receiver operator characteristic curve; the negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were calculated.

RESULTSNinety-six cases (28.6%) were definitely diagnosed as PE among 336 cases, among them 56 cases (58.3%) were ≥65 years old. The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%, respectively (P < 0.05) in the elderly patients; the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]: 0.612-0.746) and 0.655 (95% CI: 0.584-0.722), respectively (P = 0.389). The negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were 93.7%, 100%, and 100% in the elderly, respectively.

CONCLUSIONSThe diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE. The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.

Aged ; Aged, 80 and over ; Angiography ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Pulmonary Embolism ; diagnosis ; diagnostic imaging ; metabolism ; Retrospective Studies

OBJECTIVETo analyze the relation of plasma D-dimer levels and incidence of deep venous thrombosis after spinal surgery.

METHODSThe clinical data of 63 patients underwent spinal surgery from October 2009 to October 2010 were retrospective analyzed. There were 40 males and 23 females with an average age of 48 years old(21 to 76) in operation. Operation levels of 15 cases were in cervical vertebrae, 4 cases were in thoracic vertebrae,and 44 cases were in lumbar vertebrae. Thirty patients with spinal fracture were caused by trauma and 33 patients without trauma, 11 patients combined with nerve injury. The patients were divided into two groups according to plasma D-dimer levels, more than or equal to 500 microg/L was D-dimer positive group and less than 500 microg/L was D-dimer negative group. Venous blood of all patients early morning with empty stomach were testd on admission, and at 2 h, 1 d, 2 d, 3 d, 4 d, 6 d, 8 d, 10 d, 15 d after operation,respectively.

RESULTSThere was no statistically significant differences in sex, operative segments, implants, operative posture, age, bleed volume, body weight, peroperative D-dimer levels between two groups. After operation, plasma D-dimer of 19 patients were more than or equal to 500 microg/L, with persistent or progressive increasing. Two cases occurred deep venous thrombosis in D-dimer positive group, they respectively were found at 3 days and 8 days after operation. Both of them underwent posterior decompression and internal fixation. However,no deep venous thrombosis was found in D-dimer negative group.

CONCLUSIONPostoperative D-dimer assay can effective predict deep venous thrombosis occurrence. D-dimer level more than or equal to 500 microg/L will be considered as a risk factor for deep venous thrombosis after spinal surgery.

Adult ; Aged ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spine ; surgery ; Ultrasonography ; Venous Thrombosis ; blood ; diagnostic imaging ; surgery ; Young Adult