纤溶酶原激活物抑制剂1的时间动态改变在创伤性凝血功能障碍中的研究进展OA

Trauma-induced coagulopathy(TIC)is a temporally dependent coagulation imbalance closely asso-ciated with early hemorrhage and late thrombotic complications following trauma.Plasminogen activator inhibitor-1(PAI-1)plays a crucial regulatory role in the progression of TIC.Clinical sequential monitoring and experi-mental studies indicate that the early phase of trauma is characterized by fibrinolytic activation dominated by en-dothelial release of tissue-type plasminogen activator(tPA).Subsequently,under the influence of sustained hy-poperfusion and inflammatory responses,PAI-1 expression gradually increases,typically peaking 6 to 24 hours post-injury,shifting the fibrinolytic state from activation to inhibition or even shutdown.The temporal rise in PAI-1 not only contributes to maintaining hemostatic stability but may also associated with microvascular thrombo-sis and organ dysfunction.Therefore,a clinical TIC staging assessment based on the temporal dynamics of PAI-1 facilitates the identification of distinct fibrinolytic phenotypes and their respective risk windows,providing a theoretical basis for anti-fibrinolytic treatment decisions and thrombotic risk stratification.This review focuses on the temporal evolution of PAI-1 in TIC and its clinical implications.