Nomura E, Kohriyama T, Yamaguchi S, Kajikawa H, Nakamura S
Third Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
Blood Coagul Fibrinolysis. 1998 Jan;9(1):55-62. doi: 10.1097/00001721-199801000-00007.
The purposes of this study were to investigate the association between carotid atherosclerosis and hemostatic markers, and to elucidate the difference in hemostatic markers between intima-media thickening and plaque formation in patients with cerebral small artery disease. We investigated carotid atherosclerosis by assessing diffuse intima-media thickness measurements and localized plaque using B-mode ultrasonography, and we measured the concentrations of plasma fibrinogen, beta-thromboglobulin and platelet factor 4 as markers for platelet activation, and the activity of plasma von Willebrand factor as a marker for endothelial damage. The intima-media thickness was significantly associated with age, male sex, the concentrations of plasma beta-thromboglobulin and platelet factor 4, and the activity of plasma von Willebrand factor. The plaque score showed a significant association with male sex, the concentration of fibrinogen, and the activity of plasma von Willebrand factor. These results may indicate that underlying mechanisms are not the same between the intima-media thickness and plaque formation. We suggest that hemostatic markers could reflect the severity of carotid atherosclerosis in patients with cerebral small artery disease, and that preventive antiplatelet therapies against brain infarction might be necessary for patients with severe carotid atherosclerosis.
本研究的目的是调查颈动脉粥样硬化与止血标志物之间的关联，并阐明脑小血管病患者内膜中层增厚与斑块形成之间止血标志物的差异。我们通过使用B型超声评估弥漫性内膜中层厚度测量值和局部斑块来研究颈动脉粥样硬化，并且我们测量了血浆纤维蛋白原、β-血小板球蛋白和血小板因子4的浓度作为血小板活化的标志物，以及血浆血管性血友病因子的活性作为内皮损伤的标志物。内膜中层厚度与年龄、男性、血浆β-血小板球蛋白和血小板因子4的浓度以及血浆血管性血友病因子的活性显著相关。斑块评分与男性、纤维蛋白原浓度和血浆血管性血友病因子的活性显著相关。这些结果可能表明内膜中层厚度和斑块形成的潜在机制不尽相同。我们认为止血标志物可以反映脑小血管病患者颈动脉粥样硬化的严重程度，并且对于严重颈动脉粥样硬化患者可能有必要采取预防性抗血小板治疗以预防脑梗死。
