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充分定义 脑缺血发病机制中的血液流变学。 我们希望 对蛛网膜下腔出血患者进行调查，以便 定义与脑相关的血液流变学异常 缺血。 我们还希望确定之间的关系 血液流变学、血栓形成和缺血症状 至颈动脉粥样硬化斑块。 我们将调查大约 150 名患者 五年内蛛网膜下腔出血。 血液流变学因素将在他们的过程中确定 术前和出院后。 血液流变学 测定将包括粘度（全血、红细胞血浆 悬浮液和血浆）通过锥板和库埃特粘度计； 通过 zeta 沉降比测量红细胞聚集 聚合索引；和红细胞变形能力使用新的 电脑过滤装置。 这些血液流变学因素 将在以下情况下进行评估： 1) 临床，如 通过反复的神经学评估确定； 2） 动脉造影，根据是否存在血管痉挛来确定； 3） 通过 CT 扫描确定脑积水； 4) 血小板 凝血系统的激活和其他要素，如 通过测量血浆β-血栓球蛋白来确定， 连同纤维蛋白肽 A 和 B、纤溶酶原、α 2- 抗纤溶酶和组织纤溶酶原激活剂抑制剂； 5) 血 体积状态，通过 51 铬法测量；和 6) 深静脉血栓形成，根据临床和 I-125 确定 四肢纤维蛋白原扫描。 我们将分析大约 350 例颈动脉内膜切除术 五年内的样本。 之间的关系 血液流变学因素和颈动脉血栓活动 将使用免疫过氧化物酶染色剂评估斑块表面 用于纤维蛋白和β-血栓球蛋白。 斑块区域 承受高剪切应力和低剪切应力将通过以下方式确定 病理和动脉造影分析。 免疫组织学 颈动脉粥样硬化斑块的特征 在这些流变特征的背景下进行检查。 此外， 将分析颈动脉斑块的病理特征 关于临床血液流变学异常（例如， 粘度和红细胞聚集）和凝血。 最后，我们 将检查这些血液流变学和 病理特征和缺血症状的存在 与颈动脉疾病有关。