解離性大動脈瘤における凝血学的検討
スポンサーリンク
概要
- 論文の詳細を見る
When deciding on the method of treatment for patients with dissecting aortic aneurysm (DA), the following factors should be taken into consideration: the duration of disease, the diameter of the aneurysm, and whether the pseudolumen is thrombosed. Coagulation and fiblolytic activity were investigated in the acute phase (1-14 days from the onset), subacute phase (15-56 days), and chronic phase (>57 days) of DA, and the aneurysms were classified as thrombosed type (type T) or open communicated type (type O). Eighty-six patients (56 men and 30 women) with DA were studied. Twenty-three patients had DeBakey type I aneurysms, while 4 had type II, 7 had type Ilia, and 52 had type Illb. Thirty-five patients had type T disease and 51 had type O. We measured thrombin-antithrombin III complex (TAT), prothrombin fragment 1+2 (F_<1+2>), tissue plasminogen activator (t-PA), plasminogen activator inhibitor activity (PAIact), D-dimer, β-thromboglobulin (β-TG), and platelet factor 4 (PF4) levels. All patients with DA showed secondary hypercoagulability and hyperfibrinolysis in the acute phase, so they were recognized to be in a pre-DIC state. Type T patients showed hypercoagulability and the onset of thrombus formation in the dilated pseudolumen was suggested to occur in early acute phase due to elevated TAT and β-TG levels. Type O patients showed increased secondary fibrinolysis, because D-dimer levels were higher than in type T patients during each phase. The maximum aneurysm diameter and changes of coagulation parameters were correlated positively in type T patients during the acute and chronic phases, and in type O patients during the acute phase, so these patients were recognized to be in the pre-DIC state. No significant changes were seen in coagulation parameters between the preoperative and postoperative periods in both types of DA, probably due to the effect of graft inplantation and residual dissection of the aorta. This study suggested that mesurement of coagulation parameters may be useful in distinguishing type T and type O aneurysm, and may help to decide on the treatment of DA.
- 東京女子医科大学の論文
- 1996-12-25
著者
関連論文
- 4.解離性大動脈瘤における凝血学的検討 : 解離腔の血栓閉塞の指標となり得るか(一般演題,第16回東京女子医科大学血栓止血研究会,学術情報)
- 4.肺血栓塞栓症の臨床的凝血学的検討(一般演題,第15回東京女子医科大学血栓止血研究会,学術情報)
- 4.当科外来における心房細動症例の臨床的検討 : 血栓塞栓症を中心に(一般演題,第17回東京女子医科大学血栓止血研究会,学術情報)
- 弁膜症に伴う心房細動(valvular AF;VAF)と弁膜症以外の心房細動(non-valvular AF;NVAF)との凝血学的検討 : ポスター発表 : 第57回日本循環器学会学術集会
- 解離性大動脈瘤における凝血学的検討(学位論文の内容の要旨および審査の結果の要旨 第37集(平成10年5月))
- 62)炎症性腹部大動脈瘤に仮性大動脈瘤を合併した1例(日本循環器学会第152回関東甲信越地方会)
- 心筋梗塞例における右室駆出率の検討 : ポスター発表 : 第57回日本循環器学会学術集会
- P173 血管内皮におけるPeroxisome Proliferator-Activated Receptor(PPARα)の役割
- 0422 冠動脈疾患の遺伝的背景について
- 0425 冠動脈疾患における遺伝的背景 : EcNOS遺伝子、glycoprotin IIIa遺伝子多型性と本邦における冠動脈病変との関連について
- 月経周期における心肺機能の変化
- 4.冠動脈粥腫破綻におけるCD4 T細胞誘導性血管平滑筋アポトーシスとTNFαの研究(佐竹高子研究奨励賞受賞者研究発表,第335回東京女子医科大学学会例会)
- 粥腫不安定化マーカー (特集 循環器領域のバイオマーカーをどう利用するか)
- 解離性大動脈瘤における凝血学的検討
- 急性冠症候群とT細胞
- 動脈硬化と免疫異常 (特集 動脈硬化症--一次予防から二次予防まで)
- 妊娠期間中のビタミンC摂取不足が胎仔や新生仔に異常な心拡張を引き起こす(研究論文紹介)