Hemostatic activation in spontaneous intracerebral hemorrhage

被引:56
作者
Fujii, Y
Takeuchi, S
Harada, A
Abe, H
Sasaki, O
Tanaka, R
机构
[1] Niigata Univ, Brain Res Inst, Dept Integrated Neurosci, Niigata 9518585, Japan
[2] Niigata Univ, Brain Res Inst, Dept Neurosurg, Niigata 9518585, Japan
关键词
blood coagulation; cerebral ventricles; hemostasis; intracerebral hemorrhage; subarachnoid hemorrhage;
D O I
10.1161/01.STR.32.4.883
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-There is no in-depth information available on the changes in hemostatic systems in patients in the acute phase of spontaneous intracerebral hemorrhage (ICH). This study was conducted to assess the relationships between the changes in hemostatic systems and clinical parameters in patients in acute-phase ICH. Methods-The records of 358 patients admitted within 6 hours of onset of ICH were reviewed to examine the relationships between changes in hemostatic systems and computed tomographic findings and clinical parameters. Results-The white blood cell counts and the levels of thrombin-antithrombin complex, plasmin-antiplasmin complex, and D-dimer in patients with intraventricular extension (IVE) or subarachnoid hemorrhage (SAH) were significantly (P<0.05) higher than those in patients without IVE or SAH. Most of the hemostatic system parameters in patients without IVE or SAH showed no significant differences compared with normal subjects. Multiple linear regression analysis revealed that the levels of thrombin-antithrombin complex significantly increased with an increase in the amount of SAH (P<0.001) and IVE (P<0.001). The levels of thrombin-antithrombin complex were not significantly associated with the volume of intraparenchymal hematoma. The level of the complex, however, was significantly (P<0.001) and independently associated with the presence of IVE or SAH (multiple logistic regression analysis). Conclusions-The systemic activation of hemostatic systems in ICH patients seems to take place only when blood reaches the subarachnoid space. The intraparenchymal hematoma itself seems unlikely to activate hemostatic systems in peripheral blood, although the hematoma is expected to cause local activation of hemostatic systems.
引用
收藏
页码:883 / 890
页数:8
相关论文
共 46 条
[1]  
ALTES A, 1995, ACTA HAEMATOL-BASEL, V94, P10
[2]   PROACT: A phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke [J].
del Zoppo, GJ ;
Higashida, RT ;
Furlan, AJ ;
Pessin, MS ;
Rowley, HA ;
Gent, M .
STROKE, 1998, 29 (01) :4-11
[3]   RECOMBINANT TISSUE PLASMINOGEN-ACTIVATOR IN ACUTE THROMBOTIC AND EMBOLIC STROKE [J].
DELZOPPO, GJ ;
POECK, K ;
PESSIN, MS ;
WOLPERT, SM ;
FURLAN, AJ ;
FERBERT, A ;
ALBERTS, MJ ;
ZIVIN, JA ;
WECHSLER, L ;
BUSSE, O ;
GREENLEE, R ;
BRASS, L ;
MOHR, JP ;
FELDMANN, E ;
HACKE, W ;
KASE, CS ;
BILLER, J ;
GRESS, D ;
OTIS, SM .
ANNALS OF NEUROLOGY, 1992, 32 (01) :78-86
[4]   HEMORRHAGIC TRANSFORMATION FOLLOWING TISSUE PLASMINOGEN-ACTIVATOR IN EXPERIMENTAL CEREBRAL INFARCTION [J].
DELZOPPO, GJ ;
COPELAND, BR ;
ANDERCHEK, K ;
HACKE, W ;
KOZIOL, JA .
STROKE, 1990, 21 (04) :596-601
[5]  
DELZOPPO GJ, 1992, THROMB HAEMOSTASIS, V68, P642
[6]  
DRAKE TA, 1989, AM J PATHOL, V134, P1087
[7]   Hemorrhagic transformation within 36 hours of a cerebral infarct - Relationships with early clinical deterioration and 3-month outcome in the European Cooperative Acute Stroke Study I (ECASS I) cohort [J].
Fiorelli, M ;
Bastianello, S ;
von Kummer, R ;
del Zoppo, GJ ;
Larrue, V ;
Lesaffre, E ;
Ringleb, AP ;
Lorenzano, S ;
Manelfe, C ;
Bozzao, L .
STROKE, 1999, 30 (11) :2280-2284
[8]  
FISHER CM, 1951, J NEUROPATH EXP NEUR, V10, P92
[9]   CYCLOSPORINE-A AUGMENTS HUMAN PLATELET SENSITIVITY TO AGGREGATING AGENTS BY INCREASING FIBRINOGEN RECEPTOR AVAILABILITY [J].
FISHMAN, SJ ;
WYLONIS, LJ ;
GLICKMAN, JD ;
COOK, JJ ;
WARSAW, DS ;
FISHER, CA ;
JORKASKY, DJ ;
NIEWIAROWSKI, S ;
ADDONIZIO, VP .
JOURNAL OF SURGICAL RESEARCH, 1991, 51 (02) :93-98
[10]   LOCALIZATION OF HUMAN TISSUE FACTOR ANTIGEN BY IMMUNOSTAINING WITH MONOSPECIFIC, POLYCLONAL ANTI-HUMAN TISSUE FACTOR ANTIBODY [J].
FLECK, RA ;
RAO, LVM ;
RAPAPORT, SI ;
VARKI, N .
THROMBOSIS RESEARCH, 1990, 57 (05) :765-781