Takahashi H, Wada K, Satoh N, Takakuwa E, Furuta R, Yoshino N, Shibata A
First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Blood Coagul Fibrinolysis. 1993 Jun;4(3):435-9. doi: 10.1097/00001721-199306000-00007.
To assess the degree of haemostatic system activation, plasma levels of prothrombin fragment 1 + 2 (F1 + 2), a direct indicator for thrombin generation in vivo, were measured in 49 patients with thrombotic disease undergoing long-term warfarin therapy (Thrombotest values < or = 40%). In these patients, vitamin K dependent coagulation factors (factors II, VII, IX and X) were decreased together with the anticoagulant proteins C and S, but the mean plasma concentration of F1 + 2 was significantly decreased compared with 48 healthy subjects. In warfarin-treated patients, F1 + 2 was positively correlated with the Thrombotest value, factors II, VII, IX and X. When analysed according to the intensity of anticoagulation, patients with Thrombotest values less than 30% showed a significant decrease in F1 + 2, but the mean F1 + 2 level was normal in patients with Thrombotests higher than 30%. These findings indicate that long-term oral anticoagulant therapy suppresses thrombin generation approximately in parallel to the decrease in coagulation factors, and levels of F1 + 2 lower than healthy subjects are observed when Thrombotest values are less than 30%.
为评估止血系统激活程度，我们检测了49例接受长期华法林治疗（凝血酶原时间值≤40%）的血栓性疾病患者体内凝血酶原片段1 + 2（F1 + 2）的血浆水平，F1 + 2是体内凝血酶生成的直接指标。这些患者体内维生素K依赖的凝血因子（因子II、VII、IX和X）以及抗凝蛋白C和S均减少，但与48名健康受试者相比，F1 + 2的平均血浆浓度显著降低。在接受华法林治疗的患者中，F1 + 2与凝血酶原时间值、因子II、VII、IX和X呈正相关。根据抗凝强度分析，凝血酶原时间值低于30%的患者F1 + 2显著降低，但凝血酶原时间值高于30%的患者F1 + 2平均水平正常。这些结果表明，长期口服抗凝治疗抑制凝血酶生成的程度大致与凝血因子的减少程度平行，当凝血酶原时间值低于30%时，可观察到F1 + 2水平低于健康受试者。
