Association of hemostatic factors with peripheral vascular disease.
Association of hemostatic factors with peripheral vascular disease.
复制标题
止血因素与周围血管疾病的关联。
DOI：
10.1016/s0002-8703(97)80024-5
复制
发表时间：
1997
影响因子：
4.8
通讯作者：
Kostis,JB
中科院分区：
文献类型：
--
作者：
Philipp,CS;Cisar,LA;Kim,HC;Wilson,AC;Saidi,P;Kostis,JB
止血危险因素在冠状动脉疾病中已得到很好的研究，但在外周血管疾病中的研究较少。凝血和纤溶蛋白与下肢动脉闭塞疾病和其他血管危险因素的关系尚不清楚。对46名参加动脉疾病多项干预试验(ADAD)的成人受试者和76名对照组的纤维蛋白原、凝血因子VII活性、血管性血友病因子(VWF)抗原和纤溶酶原激活物抑制物-1(PAI-1)活性进行了检测，并与衡量下肢动脉狭窄程度的踝臂收缩压指数(ABI)相关。入学研究人群的主要纳入标准是平均两个ABI<；0.85。纤维蛋白原和纤溶酶原激活物抑制物-1在入院组显著高于对照组(分别为331±52 mg/dl和273±46 mg/dl，P<0.0001)；纤维蛋白原与ABI、凝血因子VII活性、收缩压和舒张压相关，PAI-1与体重指数、年龄相关，凝血因子VII活性与胆固醇水平相关。Logistic回归分析表明，在该人群中，纤维蛋白原和收缩压与ABI状态独立相关，考虑了止血变量和几个已知的外周动脉疾病非止血危险因素。结果表明，纤维蛋白原水平与下肢动脉狭窄的存在有很强的独立相关性。PAI-1水平在入院患者中升高，但多变量分析并未显示PAI-1与ABI之间存在独立关系。
Hemostatic risk factors have been well established in coronary artery disease but less well studied in peripheral vascular disease. The relationship of coagulation and fibrinolytic proteins to lower limb arterial occlusive disease and other vascular risk factors remains poorly defined. Fibrinogen, factor VII coagulant activity, von Willebrand factor (vWf) antigen, and plasminogen activator inhibitor-1 (PAI-1) activity were measured in 46 adult participants in the Arterial Disease Multiple Intervention Trial (ADMIT) and in 76 control subjects and related to ankle-brachial systolic pressure index (ABI), a measure of lower limb arterial stenosis. The primary inclusion criterion for the ADMIT study population was an average of two ABIs<0.85. Fibrinogen and PAI-1 in ADMIT subjects were significantly higher than in control subjects (331±52 mg/dl vs 273±46 mg/dl, p<0.0001; 18.7±10 units/ml vs 13.5±8.9 units/ml, p<0.04). There were significant correlations of fibrinogen with ABI, factor VII coagulant activity, and systolic and diastolic blood pressures; PAI-1 with body mass index and age; and factor VII coagulant activity with cholesterol levels. Logistic regression analysis, considering hemostatic variables and several known nonhemostatic risk factors of peripheral arterial disease, showed that fibrinogen and systolic blood pressure were independently associated with ABI status in this population. The results demonstrate a strong independent correlation between fibrinogen levels and the presence of lower limb arterial stenosis. PAI-1 levels were elevated in ADMIT participants, but multivariate analysis did not demonstrate an independent relationship between PAI-1 and ABI.