[Thrombosis and splenectomy. Preliminary note on the changes of various blood coagulation parameters 20 days after splenectomy. Experimental research].
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Biomedical subjects
Publications and source records attributed to G Avellone.
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In 40 patients suffering from chronic ischemic heart disease (16 with history of myocardial infarction, 10 with unstable angina and 14 with stable angina) and in an equal number of sex-and age-matched control subjects, we have determined plasma and blood viscosity according to RAND et al. using a Wells-Brookfield Micro-Viscometer, shear rate 230 sec-1, and red cell filterability according to REID et al. Significant differences were found in patients suffering from ischemic heart disease, in comparison with the control group, for blood viscosity (p less than 0.01), plasma viscosity (p less than 0.001) and red cell filterability (p less than 0.001). The changes of hemorheological parameters in ischemic heart disease, especially in patients suffering from unstable angina and in those with history of myocardial infarction, point to the opportunity of a pharmacological treatment aiming at improving the district microcirculation.
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The effect of a 3 month daily administration of 800 mg pentoxifylline (Trental 400 bds) or placebo was assessed under double blind crossover design in 18 patients (12 males and 6 females) with peripheral occlusive arterial disease in respect of painfree walking distance and various hemorheological and hemostasiological variables, platelet aggregation, serum cholesterol and triglycerides. In first treatment period walking distance significantly increased with pentoxifylline by 46% from baseline 121 +/- 15 m and by 4% with placebo from baseline 134 +/- 18 m. Pentoxifylline administration furthermore yielded significant decrease in whole blood and plasma viscosity and significant increase in erythrocyte deformability. This was paralleled by distinct reduction of fibrinogen, platelet aggregation and euglobulin lysis time, also plethysmographic variables showed positive changes pointing to improvement of limb perfusion. The results of the study suggest that treatment of peripheral occlusive vascular disease by a drug improving blood fluidity through correction of hemorheological and hemostasiological factors turns especially promising and beneficial since the action centers finally on the languishing microcirculation in the ischemic tissue.
Red blood cell filterability was compared with some blood coagulation parameters in 50 patients suffering from atherosclerosis obliterans of lower limbs at stages II, III and IV. The reduced red blood cell filterability correlated positively with the stage of the arterial disease (r = 0.8185), with levels of plasma fibrinogen (r = 0.8366) and with the euglobulin lysis time (r = 0.8124), while negative correlations with platelet reactivity threshold (r = 0.6928) and with antithrombin III activity (r = 0.6557) were found. The authors believe that in the therapy of these vascular diseases it is necessary to modify the reduced red blood cell filterability together with the blood coagulation order.
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