胸主动脉内自发性回声增强与血浆血管性血友病因子之间的关系。

Relationship between spontaneous echo contrast in the thoracic aorta and plasma von Willebrand factor.

作者信息

Inoue Takuya, Suzuki Makoto, Namiki Atsushi, Hirai Hironori, Sugi Kaoru

机构信息

Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro, Tokyo, 153-8515, Japan.

Center for Clinical Training and Education, Toho University, Tokyo, Japan.

出版信息

J Med Ultrason (2001). 2006 Dec;33(4):225-30. doi: 10.1007/s10396-006-0114-y. Epub 2006 Dec 22.

DOI:10.1007/s10396-006-0114-y

PMID:27277979

Abstract

PURPOSE

To clarify the relationships between spontaneous echo contrast (SEC) detected by transesophageal echocardiography (TEE) and coagulopathy, ultrasonographic findings that may correlate to biochemical coagulation markers were examined.

METHODS

TEE was performed on 49 consecutive patients (mean age 64 ± 14 years; 28 men, 21 women). Blood samples were taken at the same time as TEE was carried out. Aortic SEC (Ao-SEC) and left atrial SEC (LA-SEC) were classified into three grades: absent, mild and marked. Levels of von Willebrand factor (vWF), thrombin antithrombin III complex (TAT), prothrombin fragments 1+2 (F1+2) and fibrinopeptide A (FPA) were measured.

RESULTS

Mean plasma vWF levels by Ao-SEC grade were 144 ± 39% for absent, 177 ± 55% for mild and 210 ± 73% for marked, with significantly higher levels in the Ao-SEC marked group than in the Ao-SEC absent group (P < 0.05). Mean plasma vWF levels by LA-SEC were 185 ± 73% for absent, 180 ± 49% for mild and 201 ± 62% for marked, with no significant differences apparent between groups. Moreover, no relationships were identified between Ao-SEC grade and plasma levels of coagulation indicators TAT, F1+2 and FPA.

CONCLUSION

Plasma vWF levels correlated to grade of aortic SEC. Characteristics of the coagulation system differ between Ao-SEC and LA-SEC. Ao-SEC offers a clinical indicator of platelet thrombus formation.

摘要

目的

为阐明经食管超声心动图（TEE）检测到的自发回声造影（SEC）与凝血病之间的关系，对可能与生化凝血标志物相关的超声检查结果进行了研究。

方法

对49例连续患者（平均年龄64±14岁；男性28例，女性21例）进行TEE检查。在进行TEE检查的同时采集血样。将主动脉SEC（Ao-SEC）和左心房SEC（LA-SEC）分为三个等级：无、轻度和重度。检测血管性血友病因子（vWF）、凝血酶抗凝血酶III复合物（TAT）、凝血酶原片段1+2（F1+2）和纤维蛋白肽A（FPA）的水平。

结果

按Ao-SEC等级分组，血浆vWF平均水平在无Ao-SEC组为144±39%，轻度Ao-SEC组为177±55%，重度Ao-SEC组为210±73%，重度Ao-SEC组水平显著高于无Ao-SEC组（P<0.05）。按LA-SEC分组，血浆vWF平均水平在无LA-SEC组为185±73%，轻度LA-SEC组为180±49%，重度LA-SEC组为201±62%，各组间无明显差异。此外，未发现Ao-SEC等级与凝血指标TAT、F1+2和FPA的血浆水平之间存在相关性。