Fibrinolysis and spinal injury. Relationship to post-traumatic deep vein thrombosis

Tissue plasminogen activator (t-PA) activity and antigen (t-PA:Ag) at rest and after venous occlusion (VO), were measured on admission to hospital in 9 patients with acute spinal cord injury (SCI) (group P) and in 12 patients who were immobilized due to a fracture of the cervical spine without paralysis (group C). In addition, the levels of t-PA:Ag, t-PA activity, t-PA inhibitor activity (PAI), the von Willebrand factor (vWF:Ag), F VIII:C and fibrinogen were monitored until the 10th post-traumatic day. Venous thrombosis (VT) was detected by the 125I-labelled fibrinogen test in 78% in group P and in 8% in group C. The median t-PA activity after VO was 8.6 IU/ml and 41.6 IU/ml in groups P and C, respectively (p less than 0.01). The t-PA:Ag increased similarly during VO in both groups and reached a level of 55.0 ng/ml in group P and 64.9 ng/ml in group C. The median level of PAI activity before VO was 19.2 U/ml in group P and 15.8 U/ml in group C. The trend of higher PAI values in group P than in C was more pronounced after VO (13.4 U/ml vs. 2.0 U/ml). High individual levels of PAI were found during the first 72 h of immobilization in both group P and group C. The levels of vWF:Ag and fibrinogen were significantly higher in group P than in group C on the 6th and 10th post-traumatic days and the level of FVIII:C on the 10th day.(ABSTRACT TRUNCATED AT 250 WORDS)