Landi G, Barbarotto R, Morabito A, D'Angelo A, Mannuccio Mannucci P
Department of Neurology, Ospedale Policlinico, University of Milano, Italy.
Stroke. 1990 Mar;21(3):424-7. doi: 10.1161/01.str.21.3.424.
We measured levels of fibrinopeptide A, beta-thromboglobulin, and fibrinogen in the plasma of 27 patients 2 months after their first stroke. Concentrations of fibrinopeptide A, a sensitive index of in vivo hypercoagulability, were significantly higher in the 18 ischemic stroke patients than in 40 age- and sex-matched controls and in the six patients who experienced recurrence within 5 years than in the 12 who remained asymptomatic. On the contrary, fibrinopeptide A levels had no prognostic significance among the nine patients with hemorrhagic stroke. Concentrations of beta-thromboglobulin, an index of platelet activation, were higher in the 27 stroke patients than in the 40 controls, but this index was not associated with stroke recurrence. Fibrinogen levels were not significantly higher in stroke patients than in controls. In a multivariate regression analysis of hemostatic and clinical variables, only fibrinopeptide A levels of greater than 4 ng/ml were significantly related to cerebral infarction. Our results support the role of hypercoagulability in the recurrence of ischemic stroke and may allow identification of subjects at high risk for it. If confirmed in more patients, our results could provide a rationale for clinical trials of anticoagulant therapy in such patients.
我们检测了27例首次中风患者在中风后2个月时血浆中纤维蛋白肽A、β-血小板球蛋白和纤维蛋白原的水平。纤维蛋白肽A是体内高凝状态的敏感指标，18例缺血性中风患者的纤维蛋白肽A浓度显著高于40例年龄和性别匹配的对照者，5年内复发的6例患者的纤维蛋白肽A浓度显著高于12例无症状患者。相反，在9例出血性中风患者中，纤维蛋白肽A水平无预后意义。β-血小板球蛋白是血小板活化指标，27例中风患者的β-血小板球蛋白浓度高于40例对照者，但该指标与中风复发无关。中风患者的纤维蛋白原水平与对照者相比无显著升高。在对止血和临床变量的多因素回归分析中，只有纤维蛋白肽A水平大于4 ng/ml与脑梗死显著相关。我们的结果支持高凝状态在缺血性中风复发中的作用，并可能有助于识别高危患者。如果在更多患者中得到证实，我们的结果可为这类患者的抗凝治疗临床试验提供理论依据。
