Factor VIIa and tissue factor procoagulant activity in diabetes mellitus after acute ischemic stroke: Impact of hyperglycemia
Factor VIIa and tissue factor procoagulant activity in diabetes mellitus after acute ischemic stroke: Impact of hyperglycemia
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DOI：
10.1160/th06-12-0719
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发表时间：
2007-11-01
影响因子：
6.7
通讯作者：
Rao, A. Koneti
中科院分区：
文献类型：
--
作者：
Gentile, Nina T.;Vaidyula, Vijender R.;Rao, A. Koneti
凝血功能的改变可能解释了急性缺血性卒中后糖尿病和高血糖患者神经预后较差的原因。研究了10例2型糖尿病患者和1例非糖尿病非糖尿病患者基线及发病后6、12、24、48h糖尿病、高血糖、全血组织因子促凝血活性(TF-PCA)和血浆因子VIIa(FVIIa)的关系。此外，我们还检测了血浆凝血酶原片段1+2(F1.2)和凝血酶-抗凝血酶复合体(TAT)作为凝血酶生成的标志物。美国国立卫生研究院卒中评定量表(NIHSS)评估的卒中严重程度在基线时相似(p=0.26)，但糖尿病组(8.20+/-4.3h)比非糖尿病组(2.67+/-2.1p=0.023)更差。在发病时，糖尿病组的FVIIa(p=0.004)和Tf-Pca(p=0.027)高于非糖尿病组，但均高于正常对照组。糖尿病患者在卒中后6、12、24小时FVIIa水平仍较高。在糖尿病患者中，FVIIa(r=0.4，p=0.02)和Tf-PCA(r=0.50，p=0.02)与血糖相关，FVIIa与血浆F1.2(r=0.34，p=0.002)和TAT(r=0.62，p=0.02)相关。
Alterations in blood coagulation may explain the poorer neurological outcome with diabetes mellitus and hyperglycemia after acute ischemic stroke. We studied the relationships between diabetes mellitus, hyperglycemia, whole blood tissue factor procoagulant activity (TF-PCA) and plasma factor VIIa (FVIIa) in ten patients with type 2 diabetes mellitus and I I non-diabetic patients at baseline and 6, 12, 24, and 48 hours (h) after presentation for acute stroke. In addition, we examined plasma prothrombin fragment 1+2 (F 1.2) and thrombin-antithrombin complexes (TAT) as markers of thrombin generation. Stroke severity, assessed by National Institute of Health Stroke Scale (NIHSS), was similar at baseline (p=0.26) but worse in diabetic (8.20 +/- 4.3) than nondiabetic patients (2.67 +/- 2.1, p=0.023) at 48 h.At presentation, diabetic patients had higher FVIIa (p=0.004) and lower TF-PCA (p=0.027) than non-diabetic patients but both were higher than in normal control subjects. FVIIa levels remained higher in diabetic patients at 6, 12 and 24 h after stroke. In diabetic patients, FVIIa (r=0.40, p=0.02) and TF-PCA (r=0.50, p=0.02) correlated with blood glucose; and, FVIIa correlated with plasma F 1.2 (r=0.34, p=0.002) and TAT levels (r=0.62, p