Blood coagulation and fibrinolysis in Buerger's disease
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概要
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Buerger's disease (Thromboangiitis Obliterans) is an inflammatory type of obliterative vascular disease affecting chiefly the peripheral arteries and veins, especially of males during adult life. Although many agents, toxins and infections have been suggested, any clear explanation has not received general acceptance. Smoking is bad to this disease, the treatment of unrepaired ulcer in Buerger's disease is lumbar sympathectomy, and, when gangrene is present, amputation.Purpose:In Buerger's disease thrombous formation is one of the most essential pathological findings. In this paper the changes of blood coagulation and fibrinolysis in 82 cases of this disease was reported.Methods:The following coagulation parameters were examined; platelet adhesiveness by modified method of Hellem II, platelet aggregation induced with ADP or collagen, antithrombin III by single radial immunodiffusion and heparin resistance by modified method of Holger Madsen.Results:Out of 82 patients 3 cases were females and 79 males, mean age 43 and average age of onset of symptom was 38.8. Coagulation data were shown in Table 1, and it was revealed that, 1) Primary bleeding time was prolonged slightly.2) Second bleeding time was remained within normal.3) APTT, PT were remained within normal but heparin resistance was increased and antithrombin III was decreased. Values of APTT as well as PT was not correlated with the severity of ulcer formation. The change of heparin resistance was varied from 12sec to 400sec, and appartently correlated with ulcer formation. In respective case, the clinical fluctuation of leg ulcer was well correlated with heparin resistance. Antithrombin III was decreased in these cases but increased after treatment not to correlate with ulcer formation itself.Conclusion:1) Heparin Resistance is increased to 26.8+8.9sec in Buerger's disease.2) In the stage of ulcer formation both of heparin resistance and antithrombin III was increased, but heparin resistance was decreased and antithrombin III was increased when ulcer disappear. From these results we can consider that Buerger's disease will be under the thrombophilic condition.
- 一般社団法人 日本血栓止血学会の論文
一般社団法人 日本血栓止血学会 | 論文
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