Analysis on the etiology and patho-physiology of neonatal thrombosis and the development of their therapy

新生儿血栓的病因、病理生理分析及治疗进展

基本信息

批准号：
17591147
负责人：
TAKAHASHI Yukihiro
金额：
$ 1.98万
依托单位：
Nara Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

项目摘要

From the nation-wide survey of neonatal thrombosis in Japan supported by this foundation, the frequency of neonatal thrombosis in Japan was one-tenth lower than that of western countries. But, this survey was retrospective, and the diagnostic criteria were not fully assured. Therefore, it is unclear whether the difference is due to the race or the diagnostic skill. However, the etiology and patho-physiology of neonatal thrombosis from this survey were similar to those of the reports from western countries. The therapy of neonatal thrombosis in Japan was mostly conservative, but the fibrinolytic therapy, such as u-PA or t-PA, was used in some cases as in adult cases. But, the doses and the timing of the fibrinolytic therapy were not assured and then it needs to establish it near future. In this survey, the incidence of the genetic factors was very low. But in our experience, the plasma levels of protein C or another anti-thrombotic factor were very low comparing with the matched-aged-co … More ntrol values. And these factors gradually reached to the control values with the growth. Therefore, the genetic factor is not to be denied but it seems that the low anti-thrombotic factor is one of the risk factors in neonatal thrombosis.Until now, the plasma levels of the coagulation and fibrinolytic factors in newborn are intensively investigated, but the recent researches and our studies demonstrate that it is important to evaluate it in the whole blood milieu included the platelets from the physiological perspective. At that time, it was suggested that the platelet-activation factors, such as small amount of thrombin and ADP exaggerated the coagulation, then, it is important to regulate these platelet-activation factors for the understanding the homeostasis and thrombosis in the newborn. From the study on the activated VII (VIIa) developed for the treatment of the bleedings in patients with hemophilia inhibiter, The VIIa pathway is important to physiologic haemostatic mechanism and Vila induced the effective homeostasis even in a few amount of platelets.It is also necessary to reveal the physiological haemostatic regulatory system. Thrombin activatable inhibitory factor (TAFI) was established by the immunological method, we continued the measurement of plasma levels in newborn at several patho-physiological conditions. We revealed the some physiological significance in the newborn homeostasis and continued the study.Finally, we will reveal the risk factors of neonatal thrombosis and establish the diagnostic criteria, and perform the prospective study near future. Less

从该基金会支持的日本全国新生儿血栓形成调查来看，日本新生儿血栓发生率比西方国家低十分之一，但该调查是回顾性的，诊断标准并不完全确定。因此，尚不清楚这种差异是由于种族还是诊断技术造成的。但是，本次调查的新生儿血栓形成的病因和病理生理学与西方国家的报告相似。大多是保守派，但纤溶治疗，如u-PA或t-PA，在某些病例中与成人病例一样使用，但纤溶治疗的剂量和时间尚未确定，需要在不久的将来确定。在本次调查中，遗传因素的发生率非常低，但根据我们的经验，与匹配年龄的对照值相比，血浆蛋白C或其他抗血栓因子的水平非常低。达到控制值因此，遗传因素不容否认，但抗血栓因子低下似乎是新生儿血栓形成的危险因素之一。目前，新生儿血浆凝血因子和纤溶因子水平较高。调查，但最近的研究和我们的研究表明，从生理角度评估包括血小板在内的全血环境很重要。当时，有人建议血小板活化因子，例如少量的血小板。凝血酶和 ADP 会加剧凝血，因此，调节这些血小板活化因子对于了解新生儿的体内平衡和血栓形成非常重要。血友病抑制剂，VIIa途径对生理止血机制很重要，Vila即使在少量血小板中也能诱导有效的稳态。揭示其生理止血机制也是必要的。通过免疫学方法建立了凝血酶激活抑制因子（TAFI），我们继续测量新生儿在几种病理生理条件下的血浆水平，揭示了其在新生儿稳态中的一些生理意义并继续研究。我们将揭示新生儿血栓形成的危险因素并建立诊断标准，并进行前瞻性研究。