脑血栓形成病人凝血状态与性激素关系的研究  

Study the Relationship Between the Coagulable State and the Sex Hormone in the Patients with Cerebral Thrombosis.

作　　者：郭为民[1] 李锦堂[1] 赵文敬 方树友[1] 

机构地区：[1]河南医科大学血液学研究所,郑州450052

出　　处：《血栓与止血学》1995年第1期1-6,46,共7页Chinese Journal of Thrombosis and Hemostasis

摘　　要：为了解脑血栓形成病人凝血状态与性激素的关系,我们对60例脑血栓形成患者和30例健康成人的性激素及凝血状态方面的一些指标进行了检测和分析,首次发现脑血栓形成病人血浆前列环素I_2(PGI_2)水平与睾酮/雌二醇(T_0/E_2)显著负相关,还发现健康成年男性血浆PGI_2浓度与血清E_2正相关。与T_0/E_2负相关;血浆抗凝血酶Ⅲ抗原(ATⅢ:Ag)和抗凝血酶Ⅲ活性(ATⅢ:A)分别与T_0和T_0/E_2显著负相关;vWF:Ag/ATⅢ:Ag与T_0和T_0/E_2显著正相关;E_2与ATⅢ:A显著正相关而与vWF:Ag显著负相关。结合以前所报道的动物实验与细胞培养中性激素对血栓形成的影响,我们认为人体内血清T_0水平及T_0/E_2比值在脑血栓形成的发病中具有重要作用。血清T_0及T_0/E_2比值升高使血浆PGI_2浓度降低,还可使男性ATⅢ:A及ATⅢ:Ag水平降低,使vWF:Ag/ATⅢ:Ag的比值升高,从而引起高凝状态,促使血栓形成。因而我们推测给予脑血栓形成病人使用小剂量雌激素可能对于提高血浆PGI_2水平,改善高凝状态有一定价值。小剂量雌激素对于具有高凝状态的停经后妇女可能具有预防血栓形成的作用。雌激素疗法可作为改善高凝状态的一个新的治疗途径。In order to further elucidate the relationship between the coagulable state in the patients with cerebral thrombosis and the endogenous sex hormone, the parameters of the sex hormone and the coagulable state in the 60 patients with cerebral thrombosis and 30 healthy adults were measured and analysed. We found for the first time that the plasma levels of 6-keto-prostaglandin F1α(6-keto-PGF1α) and the ratio of testosterone/estradiol (T0/E2) were inversely and significantly correlated in the patients with cerebral thrombosis. It was also found that the plasma levels of 6-keto-PGF1α in the healthy male adults were positively correlated to the serum E2 and negatively correlated to the ratio of T0/E2. Furthermore, we also found that the ratio of von willebrand factor/antithrombin Ⅲ antigen (vWF : Ag/AT Ⅲ : Ag) in the healthy male adults were positively correlated to the serum T0 and the ratio of T0/E2, the plasma levels of AT Ⅲ s Ag and antithrombin Ⅲ activity (AT Ⅲ : A) were negatively correlated to the serum T0 and the ratio of T0/E2 respectively. The AT Ⅲ : A was positively correlated to the serum E2 while the vWF : Ag was negatively correlated to the serum E2. Considering the effect of sex hormone on the thrombosis observed from the previous animal experiments and cell cultrue, we concluded that the serum levels of T0 and the ratio of T0/E2 played an important role in the pathogenesis of cerebral thrombosis. Serum T0 and the elevated ratio of T0/E2 suppressed plasma levels of 6-keto-PGF1α, it also reduced the plasma levels of AT Ⅲ : Ag and raised the ratio of vWF : Ag/AT Ⅲ : Ag in the male, thus it caused the hypercoagulable state and facilitated the thrombosis. With these results, we postulated that treating the patients with cerebral thrombosis with low-dosage estradiol may be useful in enhancing the plasma levels of PGI2 and improving the hypercoagulability, low-dosage estradiolmay be used in the prophylaxis of cerebral thrombosis of postmenopausal women with hypercoagulable state, and the es

关 键 词：凝血状态 性激素 脑血栓形成 

分 类 号：R743.3[医药卫生—神经病学与精神病学]