HEMORHEOLOGICAL FACTORS IN CEREBRAL ISCHEMIA

脑缺血的血液流变学因素

• 批准号: 3401692
• 负责人: MARK J FISHER
• 金额: $ 17.23万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 1984
• 资助国家: 美国
• 起止时间: 1984-07-01 至 1992-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3401692
• 关键词: atherosclerosis; blood glucose; blood tests; blood viscosity; blood volume; case history; cell aggregation; cerebral ischemia /hypoxia; cerebrovascular disorder diagnosis; clinical chemistry; diabetic angiopathy; disease /disorder proneness /risk; erythrocytes; fibrinolysis; human subject; hyperglycemia; nervous system disorder diagnosis; neurologic manifestations; platelet activating factor; prognosis; radioimmunoassay; sign /symptom; stroke; subarachnoid hemorrhage; thyroglobulin; vasospasm

The long-term goal of this project is to fully define the role of hemorheology in the pathogenesis of cerebral ischemia. We wish to investigate patients with subarachnoid hemorrhage in order to define hemorheological abnormalities related to cerebral ischemia. We also wish to determine the relationship between hemorheology, thrombosis, and ischemic symptoms with respect to carotid artery atherosclerotic plaques. We will investigate approximately 150 patients with subarachnoid hemorrhage over a period of five years. Hemorheological factors will be determined during their preoperative period and following discharge. Hemorheological determinations will include viscosity (whole blood, RBC-plasma suspension, and plasma) by cone-plate and couette viscometer; red cell aggregation measured by zeta sedimentation ratio and aggregation index; and red cell deformability using a new computerized filtration device. These hemorheological factors will be evaluated in the following contexts: 1) Clinical, as determined by repeated neurological evaluations; 2) Arteriographic, as determined by the presence of vasospasm; 3) Hydrocephalus, as determined by CT scan; 4) Platelete activation and other elements of the coagulation system, as determined by measurements of plasma beta-thromboglobulin, along with fibrinopeptides A and B, plasminogen, alpha 2- antiplasmin, and tissue plasminogen activator inhibitor; 5) Blood volume status, as measured by the chromium-51 method; and 6) Deep vein thrombosis, as determined clinically and by I-125 fibrinogen scans of the extremities. We will analyze approximately 350 carotid endarterectomy specimens over a five year period. The relationship between hemorheology factors and thrombotic activity on the carotid plaque surface will be evaluated using immunoperoxidase stains for fibrin and for beta-thromboglobulin. Regions of plaques subjected to high-and low-shear stress will be identified by pathologic and arteriographic analysis. The immunohistologic characteristics of carotid artery atherosclerotic plaques will be examined in the context of these rheologic features. In addition, pathological features of the carotid plaques will be analyzed with respect to abnormalities of clinical hemorheology (e.g., viscosity and red cell aggregation) and coagulation. Finally, we will examine the relationship between these hemorheological and pathologic features and the presence of ischemic symptoms related to carotid artery disease.

该项目的长期目标是完全定义 脑缺血发病机理中的出血学。 我们希望 调查蛛网膜下腔出血的患者 定义与脑相关的血迹学异常 缺血。 我们也希望确定 涉及出血，血栓形成和缺血性症状 到颈动脉动脉粥样硬化斑块。 我们将调查大约150名患者 五年内的蛛网膜下腔出血。 出血因素将在其期间确定 术前和出院之后。 出血学 确定将包括粘度（全血，RBC-plasma 悬架和等离子体）由锥形板和couette粘度计； 通过Zeta沉积比测量的红细胞聚集和 聚合指数；使用新的细胞可变形性 计算机过滤设备。 这些出血因素 将在以下情况下进行评估：1）临床，AS 通过重复的神经系统评估来确定； 2） 动脉造影，由血管痉挛的存在确定； 3） 通过CT扫描确定的脑积水； 4）血小板 激活和凝结系统的其他元素，AS 通过测量血浆β-拥球蛋白的测量 与纤维蛋白肽A和B一起，纤溶酶原，α2- 抗平蛋白和组织纤溶酶原激活剂抑制剂； 5）血液 体积状态，通过Chromium-51方法测量；和6） 深静脉血栓形成，如临床和I-125确定 四肢的纤维蛋白原扫描。 我们将分析大约350个颈动脉内膜切除术 在五年内的标本。 之间的关系 颈动脉上的出血因素和血小板活动 将使用免疫过氧化物酶染色评估牙菌体表面 用于纤维蛋白和β-兽素球蛋白。 斑块区域 承受高剪切应力将由 病理学和动脉分析。 免疫组织学 颈动脉动脉粥样硬化斑块的特征将是 在这些流变特征的背景下进行了检查。 此外， 将分析颈动脉斑块的病理特征 关于临床血液学异常（例如， 粘度和红细胞聚集）和凝结。 最后，我们 将检查这些肢体性学和 病理特征和缺血症状的存在 与颈动脉疾病有关。