Study on the polymerization of fibrin monomer in traumatic patients

Rui YANG; Wenning WEI; Yan YANG

ABSTRACT

BACKGROUND:

Microsurgical operation might fail due to trauma-induced hypercoagulability.

OBJECTIVE:

To observe the changes of polymerization of fibrin monomer after the treatment of trauma so as to explore an effective means for assisting the prediction of post-traumatic hypercoagulability and thrombosis.

DESIGN:

Case-control observation and self-control study.

SETTING:

Institute of Thrombus and Hemostasis, the Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.

PARTICIPANTS:

Totally 34 traumatic patients were included from those who were admitted to the Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, between May 2001 and January 2002. There were 18 males and 16 females aged 8-65 years old. Another 96 healthy people, 50 males and 46 females aged 21-68 years old, who came for routine physical examination were enrolled as normal controls. The history of coagulation impairment, and general and coagulation-related diseases were excluded in all the subjects.

METHODS:

Polymerization of plasmic fibrin monomer was detected. Fibrinogen would transform into fibrin monomers and display polymerization induced by acutobin. The accompanied changes of the turbidity were dynamically monitored using spectrophotometer at 340 nm; the obtained electrical signals were then input into the computer for statistical analysis. Venous blood samples were collected from traumatic patients immediately after hospitalization and on the 3rd day after the treatment with clinical debridement, surgery, sutures, liquid supplement and administration of antibiotics to determine polymerization of fibrin monomer. MAIN OUTCOME

MEASURES:

① The rate of polymerization of fibrin monomer (taken as the comprehensive predictor for the concentration and function of plasmic fibrinogens). ② Maximum absorbency (reflecting the amount of coagulable plasmic fibrinogen in blood specimen). ③ The ratio between the rate of polymerization of fibrin monomer and maximum ab sorbency (reflecting the polymerization of plasmic fibrinogen molecules).

RESULTS:

All participants completed the corresponding examinations and were brought into data analysis. ① In traumatic group, the rate of fibrin monomer polymerization, the content of fibrinogen, the ratio of polymerization rate to maximum absorbency were all significantly higher than those in normal control group [traumatic group 0.87±0.31, (5.81±3.22) g/L,4.61±0.97; normal control group 0.61±0.15, (3.36±1.02) g/L, 3.93±0.68,P ＜ 0.01]. ② At treatment of 3 days, although the rate of polymerization and the content of fibrinogen were found slightly declined, they were still higher than those in normal group [3.93±0.68, (4.21±1.93) g/L]; however,the ratio of polymerization rate to maximum absorbency did not change after treatment (4.68± 1.19).

CONCLUSION:

The content and function of fibrinogen would increase in traumatic patients. Traumatic patients display hypercoagulability characteristics and have thrombosis tendency. Determining the polymerization of fibrin monomer can be taken as an effective means for assisting the prediction of posttraumatic hypercoagulability and thrombosis.