Lawrence J B, Leifer D W, Moura G L, Southern P, Emery J D, Bodenheimer S L, Kramer W S
Institute of Pathology, Case Western Reserve University, Cleveland, Ohio.
Am J Med Sci. 1995 Apr;309(4):201-7. doi: 10.1097/00000441-199504000-00003.
Men have significantly more atherosclerotic disease than women. Platelet-mediated thrombosis plays a role in the initiation of myocardial infarction and stroke. Citrated whole blood from male and female donors was perfused through an annular system over everted human umbilical artery segments. Comparisons were made between platelet adherence and thrombus formation on subendothelium, platelet aggregation in citrated whole blood, hematologic variables, and the bleeding time. Platelet spreading and adherence were approximately 22% greater with male blood (P < 0.001), whereas thrombus formation on subendothelium and collagen- and arachidonic acid-induced platelet aggregation did not show sex-related differences. Platelet aggregation with adenosine diphosphate was greater in women, related to their lower hematocrit values. By contrast, in women hematocrit values showed a slight but significant positive correlation with platelet adherence on subendothelium. Fibrinogen was significantly correlated with collagen- and adenosine-diphosphate-induced platelet aggregation and with platelet adherence, spreading, and thrombus formation on subendothelium. The mean bleeding time was slightly longer in women than in men (P = 0.118). Platelet aggregation was not associated with the bleeding time except for collagen-induced platelet aggregation in males; the latter was significantly correlated with platelet adherence and spreading in both sexes, while arachidonic acid-induced platelet aggregation predicted platelet adherence and spreading in males. Male blood shows enhanced primary hemostatic activity; this may predispose men to atherosclerosis.
男性患动脉粥样硬化疾病的比例明显高于女性。血小板介导的血栓形成在心肌梗死和中风的发病过程中起作用。将来自男性和女性献血者的枸橼酸盐抗凝全血通过环形系统灌注到外翻的人脐动脉段上。对内皮细胞下的血小板黏附与血栓形成、枸橼酸盐抗凝全血中的血小板聚集、血液学变量以及出血时间进行了比较。男性血液中的血小板铺展和黏附大约高22%（P<0.001），而内皮细胞下的血栓形成以及胶原和花生四烯酸诱导的血小板聚集未显示出性别差异。女性因二磷酸腺苷诱导的血小板聚集更高，这与其较低的血细胞比容值有关。相比之下，女性的血细胞比容值与内皮细胞下的血小板黏附呈轻微但显著的正相关。纤维蛋白原与胶原和二磷酸腺苷诱导的血小板聚集以及内皮细胞下的血小板黏附、铺展和血栓形成显著相关。女性的平均出血时间略长于男性（P = 0.118）。除男性胶原诱导的血小板聚集外，血小板聚集与出血时间无关；后者与两性的血小板黏附和铺展显著相关，而花生四烯酸诱导的血小板聚集可预测男性的血小板黏附和铺展。男性血液显示出增强的初级止血活性；这可能使男性易患动脉粥样硬化。
