Rossi E C, Green D, Rosen J S, Spies S M, Jao J S
Br J Haematol. 1980 May;45(1):143-51. doi: 10.1111/j.1365-2141.1980.tb03819.x.
The relationships between factor VIII associated activities, platelet function, and venous thrombosis were studied in 18 patients with lower limb paralysis following acute spinal cord injury (SCI). Deep vein thrombosis (DVT) was detected in 13 patients (72%). Eight of the 13 thromboses were documented between 6 and 8 d following injury while the other five episodes were noted on days 11 (two), 13, 18 and 22. The detection of thrombosis was preceded by marked increases in VIIIR:Ag and VIII:RCoF whereas VIII:C was only marginally increased. The platelet aggregation response to collagen was hyperactive by the sixth day while the platelet aggregate ratio (PAR) did not become abnormal until after DVT was detected. These studies suggest a chronology in the series of events leading to DVT in patients with lower limb paralysis following SCI. Initial elevations in VIII:Ag and VIII:RCoF are followed in sequence by increased platelet responsiveness to collagen, the occurrence of DVT, and the appearance of circulating platelet aggregates. Conceivably, VIIIR:Ag elaborated by endothelial cells alters platelet reactivity and provides an important determinant for venous thrombosis.
对18例急性脊髓损伤（SCI）后下肢瘫痪患者的凝血因子VIII相关活性、血小板功能和静脉血栓形成之间的关系进行了研究。13例患者（72%）检测到深静脉血栓形成（DVT）。13例血栓中有8例在受伤后6至8天被记录，另外5例分别在第11天（2例）、13天、18天和22天被发现。在血栓形成被检测到之前，血管性血友病因子抗原（VIIIR:Ag）和VIII因子相关抗原（VIII:RCoF）显著增加，而VIII因子促凝活性（VIII:C）仅略有增加。到第6天时，血小板对胶原的聚集反应亢进，而血小板聚集率（PAR）直到检测到DVT后才变得异常。这些研究提示了SCI后下肢瘫痪患者发生DVT一系列事件的时间顺序。首先是VIII:Ag和VIII:RCoF升高，随后依次是血小板对胶原反应性增加、DVT的发生以及循环血小板聚集体的出现。可以想象，内皮细胞产生的VIIIR:Ag改变了血小板反应性，并为静脉血栓形成提供了一个重要的决定因素。
