虚血性脳血管障害における再発前血栓準備状態の臨床的定量評価の試み-若年発症脳梗塞例による解析-

临床定量评价缺血性脑血管病复发前血栓准备状态的尝试——基于年轻发病脑梗死病例的分析——

• 批准号: 07770477
• 负责人: 永山 正雄
• 金额: $ 0.51万
• 依托单位: Tokai University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07770477/
• 关键词: 虚血性脳血管障害; 血栓準備状態; 若年性脳梗塞; 凝固線溶異常

1.慢性期脳梗塞102例、健常対照37例について、凝固系活性化の指標としてthrombin-antithrombin III complex (TAT)の血中レベルを定量した。この結果、健常対照者におけるmean+2SD以上のTAT増加を atherothrombotic strokeでは37例中13例、cardioembolic strokeでは17例中7例、lacunar strokeでは48例中11例で認めた。さらにこれらの例のうち再発前4ケ月以内に測定しえた例においては、atherothrombotic strokeでは5例中5例、cardioembolic strokeでは3例中2例でTAT増加を認めた。よってTATは虚血性脳血管障害(atherothrombotic stroke, cardioembolic stroke)再発前の血栓準備状態を検出しうる鋭敏なマーカーと考えられた。2.慢性期脳梗塞82例(45歳以下の若年発症例24例、46歳以上の非若年発症例58例)および非虚血性疾患33例について、activated protein C (APC) ratio(APC添加時APTT/非添加時APTT)の測定および血液凝固第V因子の遺伝子異常(Factor V Leiden)の有無につき検討した。計3回の反復測定でAPC ratioが2.0未満、すなわちAPC resistanceを呈した例は見られず、さらにPCR法を用いた遺伝子解析によりFactor V Leidenの有無を確認したがやはり本異常は1例においても見られなかった。よってこれらの異常の虚血性脳血管障害の血栓素因としての意義は人種差が存在することを明かとした。

1. There were 102cases of chronic infarct and 37 cases of normal infarct. The blood samples were quantified by coagulant activation index (thrombin-antithrombin III complex) (TAT). The results showed that 13 of 37 patients with mean+2SD or above TAT plus atherothrombotic stroke syndrome, 7 of 17 patients with cardioembolic stroke syndrome, and 11 of 48 patients with lacunar stroke syndrome were diagnosed as having abnormal symptoms. Within 4 months of the first 4 months of follow-up, there were 5 out of 5 cases of atherothrombotic stroke infection and 2 of 3 cases of cardioembolic stroke infection. Blood vessel obstruction (atherothrombotic stroke, cardioembolic stroke) caused by deficiency of blood vessel (atherothrombotic stroke, cardioembolic stroke) was induced by thrombus preparation in the first place. two。 82 cases of chronic infarct (24 cases of infarct less than 45 years old, 58 cases of non-infarct patients over 46 years old), 33 cases of chronic non-deficiency diseases were diagnosed as chronic infarct. Activated protein C (APC) ratio (APTT when APTT/ was not added) was used to determine the frequency of factor V in blood coagulation (Factor V Leiden). A total of 3 times, there are three times to determine that the APC ratio has not been tested, and that the APC resistance has been tested again and again, and that the PCR method has been used to analyze the Factor V Leiden in the first place. Thromboxane (thromboxane) is often caused by deficiency of blood vessels. Thromboxane (thromboxane) means "poor person".