Aoki I, Aoki N, Kawano K, Shimoyama K, Maki A, Homori M, Yanagisawa A, Yamamoto M, Kawai Y, Ishikawa K
Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
J Am Coll Cardiol. 1997 Jul;30(1):91-6. doi: 10.1016/s0735-1097(97)00129-0.
We evaluated coagulability as determined by platelet-dependent thrombin generation in hypercholesterolemic patients before and after treatment with pravastatin and in hypertriglyceridemic patients to investigate the usefulness of coagulability as an index of atherosclerosis and to determine the importance of treating hyperlipidemia.
An understanding of the interaction between platelets and the plasma coagulation system is important for clarifying the mechanism of the procoagulant process.
We assessed coagulability in 58 patients with hypercholesterolemia (serum total cholesterol level > or = 220 mg/dl, age 56.5 +/- 1.5 years [mean +/- SEM]), 37 patients with hypertriglyceridemia (serum triglyceride level > or = 200 mg/dl, age 59.5 +/- 1.7 years), 13 patients with hypercholesterolemia plus hypertriglyceridemia (age 51.4 +/- 3.1 years) and 75 normal subjects (age 52.2 +/- 1.7 years). We also studied platelet-dependent thrombin generation in patients with hypercholesterolemia before and after treatment with pravastatin. Calcium chloride was added to 0.5 ml of platelet-rich plasma (150 x 10(9)/liter) to initiate coagulation. Ten microliters of the sample was transferred into 90 microliters of 3.8% sodium citrate at 10-min intervals for 30 min. A chromogenic substrate, S-2238, was added to each sample, and absorbance was measured spectrophotometrically at a wavelength of 405 nm to determine thrombin generation.
Platelet-dependent thrombin generation was increased in patients with hypercholesterolemia and patients with hypercholesterolemia plus hypertriglyceridemia (p < 0.01) compared with patients with hypertriglyceridemia and control subjects. Treatment with pravastatin normalized thrombin generation.
Hypercholesterolemia, but not hypertriglyceridemia, was associated with increased platelet-dependent thrombin generation. Pravastatin normalized the generation of thrombin.
我们评估了高胆固醇血症患者在普伐他汀治疗前后以及高甘油三酯血症患者中由血小板依赖性凝血酶生成所测定的凝血能力，以研究凝血能力作为动脉粥样硬化指标的实用性，并确定治疗高脂血症的重要性。
了解血小板与血浆凝血系统之间的相互作用对于阐明促凝过程的机制很重要。
我们评估了58例高胆固醇血症患者（血清总胆固醇水平≥220mg/dl，年龄56.5±1.5岁[平均值±标准误]）、37例高甘油三酯血症患者（血清甘油三酯水平≥200mg/dl，年龄59.5±1.7岁）、13例高胆固醇血症合并高甘油三酯血症患者（年龄51.4±3.1岁）和75名正常受试者（年龄52.2±1.7岁）的凝血能力。我们还研究了高胆固醇血症患者在普伐他汀治疗前后的血小板依赖性凝血酶生成。向0.5ml富含血小板的血浆（150×10⁹/升）中加入氯化钙以启动凝血。每隔10分钟将10微升样品转移到90微升3.8%柠檬酸钠中，共30分钟。向每个样品中加入显色底物S-2238，并在405nm波长下用分光光度计测量吸光度以确定凝血酶生成。
与高甘油三酯血症患者和对照组相比，高胆固醇血症患者以及高胆固醇血症合并高甘油三酯血症患者的血小板依赖性凝血酶生成增加（p<0.01）。普伐他汀治疗使凝血酶生成恢复正常。
高胆固醇血症而非高甘油三酯血症与血小板依赖性凝血酶生成增加有关。普伐他汀使凝血酶生成恢复正常。
