脑血管病患者的纤溶、凝血指标变化及干预治疗

A study on the changes in of plasma coagulative,fibrinolytic activities in patients with stroke and intervened treatment

目的 观察脑血管病患者正常对照者组织纤溶酶原激活物 (t -PA)、血栓调节蛋白 (TM)、组织纤溶酶原激活物抑制物 (PAI)、D -二聚体 (D -dimer)的变化及对急性脑梗死干预治疗后这些指标的变化。方法 对上述患者常规行t-PA、TM、PAI、D -dimer 4项检查 ,并对急性脑梗死患者经治疗后再查这些项目。结果 TM :急性脑梗死、急性脑出血与其他各组比较有显著性差异 (P <0 .0 1 ) ;而急性脑梗死患者治疗前与治疗后相比有明显差异 (P <0 .0 5 )。D -dimer:急性脑梗死、陈旧性脑梗死、腔隙性脑梗死组与其他各组比较有显著性差异 (P <0 .0 1 ) ;急性脑梗死与陈旧性脑梗死相比有明显差异 (P <0 .0 5 )。t-PA :急性脑出血与正常对照组之间比较有明显差异 (P <0 .0 5 ) ,急性脑出血与其他各组比较有显著性差异 (P <0 .0 1 ) ;正常对照组与其他各组比较有明显差异 (P <0 .0 5 ) ;而急性脑梗死患者治疗前与治疗后相比有明显差异 (P <0 .0 5 )。PAI:急性脑梗死与正常对照组之间比较有显著差异 (P <0 .0 1 ) ,急性脑梗死与正常对照组之外的其他组之间比较有明显差异 (P <0 .0 5 ) ,急性脑梗死治疗前后有明显差异(P <0 .0 5 )。结论 各类脑卒中存在着明显的纤溶和凝血异常 ,测定t-PA、TM、PAI、D -dimer对判断卒中的类型?

Objective To study the changes of t-PA,TM,PAI,D-dimer in patients of cerebral blood vossel diseases,normal control(NC),and the changes in acute cerebral infarction patients after intervened treatments. Methods All the patients above had the tests of t-PA,TM,PAI,D-dimer. Having been treated for 15 days,the acute cerebral infarction(ACI) patients had four tests above again. Results The plasma levels of TM in ACI and acute cerebral hemorrhage(ACH) were significantly higher than that of other groups(P<0.01);There were obviously difference in ACI groups(treated and untreated)(P<0.05).D-dimer: There were significantly discrepancy in groups of ACI,old cerebral infarction(OCI),cavity cerebral infarction(CCI) with other groups(P<0.01); There were obviously difference in ACI with OCI(P<0.05);But there were not discrepancy in OCI and CCI(P>05). The levels of D-dimer were higher in ACI without treated than that in treated group (P<0.05).t-PA: Obviously discrepancy was found between ACH and NC (P<0.05),and the levels of t-PA in ACH were significantly higher than any group of ACI,OCI,old cerebral hemorrhage(OCH),CCI(P<0.01);The levels of t-PA in NC were higher than any other groups (P<0.05);and there were obviously difference in ACI treated with untreated group (P<0.05). PAI: There were significantly discrepancy in ACI compared with NC (P<0.01); and also could find obviously discrepancy in ACI treated with untreated ACI group (P<0.05). Conclusion There are obviously abnormalities in plasma coagulative and fibrinlytic parameters in different stroke types; To check the levels of t-PA,TM,PAI,D-dimer are important to predict the stroke type,the effect of treatment,prognosis of the cases and the seriousness,and suggest that earlier treatments be important.