Burtsev E M, Shprakh V V
Zh Nevropatol Psikhiatr Im S S Korsakova. 1982;82(1):32-5.
Using the thromboelastographic method the age peculiarities of blood coagulation changes were examined in 131 patients treated for cerebral ischemias with rapid indirect-action anticoagulants (syncumar, pelentan, phenylin). In patients under 45 years of age these anticoagulants acted upon all the blood coagulation phases during the first three days of the treatment. Their use led to a lowering of the prothrombin complex activity and fibrinogen concentration as well as to activation of the anticoagulation system. In patients aged from 45 to 59 years these anticoagulants acted substantially on phases I and II of blood coagulation only, while their action on phase III was much weaker. In the elderly age group (60 to 74 years) no effect of the drugs on phase III of blood coagulation was observed. Adverse effects of the anticoagulant therapy in the forms of hemorrhagic complications and "pathological hypocoagulation" were more frequent in the middle-aged and elderly groups of the patients than in the young ones (the difference being statistically significant). The elderly patients showed more pronounced reactions to discontinuation of the anticoagulant treatment. These reactions manifested in rapid and considerable progress of hypercoagulation development.
采用血栓弹力图法，对131例使用速效间接作用抗凝剂（新双香豆素、苯丙香豆素、苯妥英钠）治疗脑缺血的患者的血液凝固变化的年龄特点进行了研究。在45岁以下的患者中，这些抗凝剂在治疗的头三天对血液凝固的所有阶段均有作用。其使用导致凝血酶原复合物活性和纤维蛋白原浓度降低，以及抗凝系统激活。在45至59岁的患者中，这些抗凝剂仅对血液凝固的I期和II期有显著作用，而对III期的作用则弱得多。在老年组（60至74岁）中，未观察到药物对血液凝固III期的影响。抗凝治疗的不良反应，以出血并发症和“病理性低凝”形式出现的，在中年和老年患者组中比在年轻患者中更频繁（差异具有统计学意义）。老年患者对抗凝治疗中断表现出更明显的反应。这些反应表现为高凝状态发展迅速且显著。
