Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
高血圧性脳内出血および頭部外傷急性期における凝固・線溶異常(予報)
Fibrinopeptide Aとfibrinopeptide Bβ15-42測定の意義について
東保 肇日野 明彦鈴木 憲三久保 哲平川 公義
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1985 年 25 巻 3 号 p. 203-208

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It is well known that abnormalities of coagulation and fibrinolysis frequently take place in the acute stage of cerebrovascular diseases and head injuries. Especially, disseminated intravascular coagulation often increases and influences the prognosis of the diseases.
Coagulation and fibrinolytic studies were performed in five cases with hypertensive intracerebral hemorrhage and one case with head injury in their acute stage. Test items were prothtombin time, partial thromboplastin time, platelet count, fibrin and fibrinogen degradation products, α2-plasmin inhibitor, antithrombin III, fibrinogen, besides, fibrinopeptide A (FPA) and fibrinopeptide Bl1542 (FPBβ). Blood was collected from the peripheral vein and the internal jugular vein at the jugular bulb. In one case with hemorrhage and the case with head injury, disseminated intravascular coagulation took place at the insults, and the tests were followed up to day 17. The following results were obtained: 1) Within twenty-four hours after the onset, FPA and FPBβ were significantly higher than the control, while the other tests were within normal limits. 2) And FPA had a tendency to be higher than FPBβ in the peripheral and jugular veins. 3) The values of FPA and FPBfl were especially high in the two cases in which disseminated intravascular coagulation broke out at the insults. 4) With heparin andor gabexate mesylate therapy, FPA and FPBβ responded faster than in the other tests.
It is assumed that damage of cerebral tissue occasionally brings about disseminated intravascular coagulation, and that FPA and FPBβ are excellent indices for predicting disseminated intravascular coagulation and for the therapy.
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