虚血性脳血管障害における抗血小板療法について—臨床的ならびに血液学的検討

ANTI-PLATELET THERAPY IN ISCHEMIC CEREBROVASCULAR DISORDER:CLINICAL AND HEMATOLOGICAL STUDY

　抄録　昭和53年1月から58年12月までに当院に入院した虚血性脳血管障害（ICVD）61例中，抗血小板療法（aspirin＋dipyridamole）を施行した51例について検討した。うち41例は新たなICVDの再発をみなかったが，残りの10例では経過中再発作が認められた。両者の間で各リスクファクターおよび他の臨床症候につき比較検討したが，有意な差はみられなかった。うち28例に対しては，血小板凝集能および血小板寿命を測定した。血小板寿命短縮例は28例中22例（79％）と高率であった。一方血小板凝集能には一定の傾向が認められなかった。抗血小板剤による治療開始後数か月の時点において比較すると，10例中9例に血小板寿命の延長を認めた。以上より，血小板寿命の測定が，抗血小板療法の開始にあたって，また治療期間中の効果判定において一つの指標になり得るものと期待される。

Anti-platelet therapy (Aspirin 250 mg/every other day~1000mg/day+Dipyridamole 150mg/day) was performed on 51 patients with ischemic cere-brovascular disorders (ICVD).

Among these patients, 41 cases showed no re-currence of ICVD attack, whereas the remaining 10 cases had re-attacks.

These 2 groups were compared from the view-point of various risk factors and other clinical findings : e. g. CT scan and angiographic appear-ance. But there was no statistically significant difference between them.

Platelet aggregability and platelet survival time were examined in twenty-eight patients out of cases. We used a simple nonradioisotope technic for the determination of platelet survival time.

Platelet survival time was shortened in 22 of 28 (79%) patients. On the other hand, platelet aggregability was found to have no definite ten-dency.

In 9 of 10 cases, platelet survival time was revealed to be prolonged several months after administration of anti-platelet drugs. There was no re-attack in 7 of these 9 patients.

Some reports also showed that platelet survival time was shortened in various thromboembolism and recovered by anti-platelet drugs.

Measurement of platelet survival time is thought to be an important method as to the indication and the monitoring of anti-platelet therapy.