Dynamic evaluation of hemostasis in the acute phase of Kawasaki disease using comprehensive coagulation functional assays.

• 資料種別: 博士論文
• タイトル: Dynamic evaluation of hemostasis in the acute phase of Kawasaki disease using comprehensive coagulation functional assays.
• 著者・編者: Yoshizawa, Hiroyuki; Nogami, Keiji; Matsumoto, Tomoko; Tsujii, Nobuyuki; Sakai, Toshiyuki; Takase, Toshio; Tanaka, Ichiro; Shima, Midori
• 著者標目: Yoshizawa, Hiroyuki; Nogami, Keiji; Matsumoto, Tomoko; Tsujii, Nobuyuki; Sakai, Toshiyuki; Takase, Toshio; Tanaka, Ichiro; Shima, Midori
• 出版事項: Elsevier
• 出版年月日等: 2019-02
• 出版年（W3CDTF）: 2019-02
• 並列タイトル等: 包括的凝固機能検査による急性期川崎病における止血動態の評価
• タイトル（掲載誌）: Thrombosis research
• 巻号年月日等（掲載誌）: 174
• 掲載巻: 174
• 掲載ページ: 76-83
• ISSN（掲載誌）: ISSN : 0049-3848
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2019-12-05
• 報告番号: 乙第1441号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: Kawasaki disease; Clot waveform analysis; Thrombin generation; Plasmin generation; Intravenous immunoglobulin therapy
• 対象利用者: 一般
• 一般注記: type:Thesis; Introduction: Kawasaki disease (KD) is a systemic vasculitis involving coronary arteries, sometimes resulting in aneurysms and myocardial infarction. Hyper-coagulability in the acute-phase of KD is indicated in some circumstances based on changes of individual clotting factors. Comprehensive coagulation assays, clot waveform analysis (CWA) and thrombin/plasmin generation assay (T/P-GA), have been developed to assess physiological hemostasis, but these techniques have not been applied in KD. Methods: We utilized both assays to analyze coagulation function in KD children (n = 42) prior to intravenous-immunoglobulin (IVIG) treatment (Pre), 1-week (1W) and 1-month (1M) post-IVIG. Results: In CWA, the clot time (CT) pre-treatment was prolonged, and was significantly shortened at 1W and 1M. However, the maximum coagulation velocity (|min1|) and acceleration (|min2|) were ~2-fold greater relative to controls, indicating an overall hypercoagulable tendency. These parameters were related to fibrinogen concentration, and were decreased at 1W and declined to normal at 1M. In T/P-GA, the endogenous potentials of thrombin and plasmin were greater relative to control at each of three time-points, and measurements at 1W were greater than those Pre-treatment. The ratios of TG and PG relative to control were similar, however, suggesting well-balanced dynamic coagulation and fibrinolysis. In non-responders to IVIG, the |min1| and |min2| measurements were greater than those in responders at 1W and 1M, suggesting that non-responders remained hypercoagulable after primary treatment. Conclusion: The coagulation data observed in KD were consistent with hypercoagulability, although fibrinolytic function appeared to be well-balanced. Comprehensive assays of this nature could provide valuable information on coagulation potential in KD.; 博士（医学）・乙第1441号・令和元年12月5日; Copyright © 2018 Elsevier Ltd. All rights reserved.; identifier:Thrombosis research Vol.174 p.76-83 (2019 Feb); identifier:00493848; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3697; identifier:Thrombosis research, 174: 76-83
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1016/j.thromres.2018.12.016
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3697/1/01%e4%b9%991441%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

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