Davì G, Ganci A, Averna M, Giammarresi C, Barbagallo C, Catalano I, Calà A, Notarbartolo A
Department of Internal Medicine, University of Palermo, Italy.
Thromb Haemost. 1995 Oct;74(4):1015-9.
Thromboxane (Tx) A2 biosynthesis is enhanced in the majority of patients with type IIa hypercholesterolemia. Because blood clotting activation is an important component of the inflammatory response, involved in the initiation and progression of atherosclerotic plaques, we have investigated TxA2 biosynthesis, neutrophil activation and thrombin generation in 24 patients with type IIa hypercholesterolemia. Urinary 11-dehydro-TxB2, was significantly higher (p = 0.0001) in patients than in 24 sex- and age matched healthy subjects. Similarly, prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin III complexes and plasma elastase were significantly higher in patients than in controls. Urinary 11-dehydro-TxB2 excretion was correlated with plasma elastase (r = 0.758; p = 0.0001), and prothrombin fragment 1 + 2 (r = 0.804; p = 0.001). The enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor simvastatin (20 mg/day for 2 months) significantly reduced cholesterol levels, urinary 11-dehydro-TxB2 excretion, plasma elastase and plasma F1 + 2 in 8 patients. We conclude that type IIa hypercholesterolemia is associated with biochemical evidence of platelet, neutrophil and blood clotting activation. The relationship between these events remains to be investigated.
大多数IIa型高胆固醇血症患者的血栓素（Tx）A2生物合成增强。由于凝血激活是炎症反应的重要组成部分，参与动脉粥样硬化斑块的发生和发展，我们对24例IIa型高胆固醇血症患者的TxA2生物合成、中性粒细胞激活和凝血酶生成进行了研究。患者尿中11-脱氢-TxB2水平显著高于24名年龄和性别匹配的健康受试者（p = 0.0001）。同样，患者的凝血酶原片段1 + 2（F1 + 2）、凝血酶-抗凝血酶III复合物和血浆弹性蛋白酶水平也显著高于对照组。尿中11-脱氢-TxB2排泄量与血浆弹性蛋白酶（r = 0.758；p = 0.0001）和凝血酶原片段1 + 2（r = 0.804；p = 0.001）相关。酶3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂辛伐他汀（20 mg/天，持续2个月）显著降低了8例患者的胆固醇水平、尿中11-脱氢-TxB2排泄量、血浆弹性蛋白酶和血浆F1 + 2。我们得出结论，IIa型高胆固醇血症与血小板、中性粒细胞和凝血激活的生化证据相关。这些事件之间的关系仍有待研究。
