著者

松田 保 村上 元孝

出版者

Japan Atherosclerosis Society

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.3, no.4, pp.447-455, 1976

---

Coagulability of blood was measured in 80 cases of acute myocardial infarction, 98 cases of acute cerebral infarction and 33 cases of acute cerebral hemorrhage. Platelet counts, activated partial thromboplastin times, prothrombin times, plasma fibrinogen content, levels of plasma antithrombin III, α₂-macroglobulin and fibrin degradation products (FDP) determined within 1 month before the attack of myocardial infarction or stroke, and those measured within 48 hours or 3 to 7 days following the onset of these diseases were compared with data obtained from 370 healthy subjects over age sixty.<br>Concentrations of plasma antithrombin III were apparently decreased before and after the development of myocardial infarction. In ten autopsied patients with acute myocardial infarction, three cases with extremely low levels of plasma antithrombin III (less than 2 mg/d<i>l</i>) were complicated with disseminated intravascular coagulation (DIC), acute cerebral infarction and/or thromboembolism of lower extremities, while no thromboembolic episodes following myocardial infarction were observed in the other seven cases in whom plasma antithrombin III concentrations were more than 20mg/d<i>l</i>. Levels of the other thrombin inhibitor in plasma than antithrombin III, i. e. α₂-macroglobulin, were increased immediately after the occurrence of cerebral hemorrhage. Plasma fibrinogen content was markedly increased after the development of myocardial infarction or cerebrovascular diseases. Activated partial thromboplastin times, prothrombin times and FDP did not significantly change before and after the development of these diseases. These data suggest that there may be a relation between development of myocardial infarction and the low levels of plasma antithrombin III. Increased levels of plasma fibrinogen, as a result of myocardial infarction or stroke, may not accelerate coagulation mechanism but act disadvantageously by elevating blood viscosity.<br>Relationship between activated partial thromboplastin times, prothrombin times, plasma fibrinogen content, levels of plasma antithrombin III, α₂-niacroglobulin or FDP, determined within 1 month before death, and grade of atherosclerosis of aorta, cerebral, coronary or femoral artery, classified grossly with the naked eye, was investigated in 186 autopsied cases without cancer or DIC, retrospectively. There were no correlations between these parameters and the grade of atherosclerosis, except that levels of FDP were significantly increased in cases with severe atherosclerosis of femoral artery. From these results, direct evidences supporting thrombogenic hypothesis of atherosclerosis suggested by Duguid were not obtained. However, atherosclerotic lesion of peripheral artery may activate clotting processes and increase FDP.