ENHANCED INVIVO PLATELET ACTIVATION IN SUBTYPES OF ISCHEMIC STROKE
ENHANCED INVIVO PLATELET ACTIVATION IN SUBTYPES OF ISCHEMIC STROKE
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DOI：
10.1161/01.str.16.4.643
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发表时间：
1985-01-01
期刊：
影响因子：
8.3
通讯作者：
COULL, BM
中科院分区：
文献类型：
--
作者：
SHAH, AB;BEAMER, N;COULL, BM
目前尚不清楚缺血性中风中的血小板活化是否是脑缺血的促成因素或继发因素。阿司匹林（ASA）预防中风的功效表明血小板活化有助于中风的发生。另一方面，血小板活化可能只是脑缺血损伤的普遍结果。为了研究这个问题，测量了 58 名患有各种确定类型的急性缺血性中风的患者的血小板特异性蛋白 β-血栓球蛋白 (β-TG) 和血小板因子 4 (PF4) 的血浆水平。 β-TG 是比 PF4 更广泛的血小板活化指标。与年龄匹配的对照组相比，血栓栓塞性和心源性卒中患者的β-TG水平显着升高（P<0.001）。此外，这些中风类别中在事件发生后第一周内抽取的样本中的 β-TG 水平显着高于随后抽取的样本（P < 0.001）。相反，腔隙性中风患者和大多数TIA[短暂性脑缺血发作]患者的β-TG水平是正常的。 β-TG 水平与通过 CT [计算机断层扫描] 扫描的面积测量法测量的脑梗塞体积不相关。此外，在中风时接受长期ASA治疗的患者中的β-TG水平与未服用ASA的相同诊断类别的患者中的β-TG水平没有差异。血小板活化对于某些（但不是全部）缺血性中风亚型可能很重要，并且即使血小板环氧合酶途径受到抑制，血小板活化也可能发生在中风中。
It remains uncertain whether platelet activation in ischemic stroke is contributory or secondary to brain ischemia. The efficacy of aspirin (ASA) in stroke prevention suggests that platelet activation contributes to the occurrence of stroke. On the other hand, platelet activation may be simply a generalized consequence of cerebral ischemic damage. To examine this issue, plasma levels of the platelet specific proteins .beta.-thromboglobulin (.beta.-TG) and platelet factor 4 (PF4) were measured in 58 patients with various defined types of acute ischemic strokes. .beta.-TG was a broader indicator of platelet activation than PF4. Compared with an age-matched control group, thromboembolic and cardioembolic stroke patients had significantly elevated .beta.-TG levels (P < 0.001). Also, .beta.-TG levels in these stroke categories were significantly higher in samples drawn within the 1st wk after the event than in those drawn later (P < 0.001). In contrast, .beta.-TG levels in lacunar stroke patients and in most TIA [transient ischemic attack] patients were normal. .beta.-TG levels did not correlate with the volume of cerebral infarction as measured by planimetry from CT [computer-tomography] scans. Moreover, .beta.-TG levels in patients on chronic ASA therapy at the time of stroke did not differ from those in patients of the same diagnostic categories not taking ASA. Platelet activation may be important in some, but not all, subtypes of ischemic stroke and that platelet activation can occur in stroke even though the platelet cyclooxygenase pathway is suppressed.