蛛网膜下腔出血继发脑血管痉挛患者凝血纤溶的动态变化研究

Dynamic changes of coagulation and fibrinolysis in the blood of patients with CVS after aneurysmal subarachnoid hemorrhage

目的了解SAH后CVS患者血液凝血、纤溶及核转录因子的动态演变情况.方法收集2004-03～2005-02神经内、外科住院SAH患者32例的外周血标本,进行出血后3 d内、5～7 d血液的PC、AT-Ⅲ、PAI-1、PAI/t～PA、NF-κB含量测定.结果出血后血浆PC明显降低,而在7 d左右降低更为明显;AT-Ⅲ水平在出血后3 d内明显升高,在7 d左右却显著降低;PAI活性在3 d内降低,7 d左右升高;PAI/t-PA的比值在7 d左右比3 d内显著升高;而NF-κB在早期即明显升高,在5～7 d达最高水平.结论凝血过程与炎性反应共同参与了SAH后CVS的发生.

Objective To investigate the variation of the coagulation, fibrinolytic system and NF - κB in the patients with CVS after SAH. Methods 32 patients with subarachnoid hemorrhage were collected. Blood was drawn to test the PC, AT - Ⅲ, PAI-1, PAL/t-PA, NF-κB in three days and 5 ～ 7 days respectively. Results The levels of PC decreased significantly after SAH, especially near a week, the activity of AT - Ⅲ increased significantly within 3 days, but decreased markedly near a week. Plasma PAI activity decreased obviously in three days, but increased significantly near a week. PAI/t-PA increased more markedly near a week than within 3 days. NF - κB increased obviously and reached the maximum in 5 ～ 7 days. Conclusion Coagulation, fibrinolytic system and NF - κB participate in the course of CVS after SAH.