Cortellaro M, Baldassarre D, Cofrancesco E, Tremoli E, Colombo A, Boschetti C, Paoletti R
Institute of Internal Medicine, University of Milan (Italy).
Stroke. 1996 Mar;27(3):450-4. doi: 10.1161/01.str.27.3.450.
Increases in common carotid intima-media thickness (CC-IMT), as measured by B-mode ultrasonography, have been widely used in both population studies and clinical trials in the search for risk factors for early atherosclerosis progression and have been found to correlate with age and with high concentrations of low-density lipoprotein cholesterol, leukocytes, and hemoglobin. We have now investigated the relation between several baseline hemostatic and conventional risk factors and CC-IMT changes over 16 months in 64 patients with peripheral arterial disease randomly selected from the prospective PLAT study series.
Samples from 24 patients (37.5%) who showed increases in CC-IMT during the follow-up period were compared with those from 40 (62.5%) in whom CC-IMT remained unchanged.
Baseline conventional risk factors and coagulation variables were similar in the two groups except for higher plasma concentrations of von Willebrand factor (vWF) (178.3 +/- 53.6% versus 141.2 +/- 53.7%, P=.01) and factor VII (FVII) (133.9 +/- 36.4% versus 107.0 +/- 27.3%, P=.001) in the patients with increased CC-IMT. CC-IMT increase correlated positively with plasma levels of FVII (r=.31, P<.01) and vWF (r=.31, P<.01). Multiple stepwise regression analysis identified FVII as the only independent variable associated with an increase in CC-IMT (beta=.83, P=.01).
High plasma concentration of FVII and vWF may be associated with the progression of early carotid atherosclerosis in patients with peripheral arterial disease.
通过B型超声测量的颈总动脉内膜中层厚度（CC-IMT）增加，已广泛应用于人群研究和临床试验，以寻找早期动脉粥样硬化进展的危险因素，并且已发现其与年龄以及低密度脂蛋白胆固醇、白细胞和血红蛋白的高浓度相关。我们现在研究了从前瞻性PLAT研究系列中随机选取的64例外周动脉疾病患者中，几种基线止血和传统危险因素与16个月内CC-IMT变化之间的关系。
将随访期间CC-IMT增加的24例患者（37.5%）的样本与CC-IMT保持不变的40例患者（62.5%）的样本进行比较。
两组的基线传统危险因素和凝血变量相似，但CC-IMT增加的患者中血管性血友病因子（vWF）的血浆浓度较高（178.3±53.6%对141.2±53.7%，P=0.01）以及因子VII（FVII）（133.9±36.4%对107.0±27.3%，P=0.001）。CC-IMT增加与FVII（r=0.31，P<0.01）和vWF（r=0.31，P<0.01）的血浆水平呈正相关。多元逐步回归分析确定FVII是与CC-IMT增加相关的唯一独立变量（β=0.83，P=0.01）。
外周动脉疾病患者中，FVII和vWF的高血浆浓度可能与早期颈动脉粥样硬化的进展有关。
