缺血性脑卒中患者急性期组织因子途径比值改变及临床意义

Changes of tissue factor pathway ratios and its clinical significance during the acute phase of ischemic stroke

目的观察缺血性脑卒中(AIS)患者急性期组织因子途径(TFP)各指标及比值的变化。方法选择AIS患者46例(AIS组)和健康体检者84例(对照组)。检测血浆复钙时间、组织因子(TF)、组织因子途径抑制物(TFPI)及比值,凝血因子各指标。结果与对照组比较,AIS组患者血浆复钙时间明显缩短(P<0.01);TF抗原及全长TFPI(fl-TFPI)含量明显增加(P<0.01),截短TFPI(tr-TFPI)含量明显降低(P<0.05);TF/tr-TFPI比值升高,tr-TFPI/fl-TFPI比值降低;血浆FⅦ:C和FⅦ:C/FⅦAg与FⅦa/FⅦAg比值明显升高,FⅦa/FⅦ:C比值明显降低(P<0.01);D-二聚体明显增高(P<0.01)。结论AIS患者急性期血液呈高凝状态,TFP比值作为高凝状态与危险因素,多项综合检测比单测更为可靠。

Objective To explore the changes of tissue factor pathway（TFP） ratios during the onset of acute ischemic stroke（AIS）. Methods Fourty six patients with AIS （AIS group）confirmed by CT and MRI and 84 healthy volunteers（control group） were observed. Plasma recalcification time,TFP factors and ratios and various coagulation factors were measured. Results Compared with the control group, plasma recalcification time was significantly shorter （P 〈0.01） ,TF antigen and full-length TFPI （fl-TFPI） significantly increased, truncated TFPI （tr-TFPI） decreased significantly （P 〈0.05）,TF/tr-TFPI ratio was significantly higher （P 〈0.01）,but tr-TFPI/fl- TFPI ratio was significantly lower in the AIS group （ P 〈0.05）. Although the levels of plasma FⅦ： C was higher （P 〈0.01）, FⅦ ： C/ FⅦAg and FⅦa/FⅦAg ratios were significantly higher （P d0.01）, FⅦa/FⅦ： C ratio was significantly lower （P 〈0.01）. In addition, plasma D-dimer was significantly higher compared with the control （P 〈0.01）. Conclusions The blood is in hypercoagulation state during the onset of AIS. TFP ratios may reflect hypercoagulation state and be the better risk factors than each index determination alone.