脑卒中患者血浆凝血酶激活的纤溶抑制物的临床研究

The clinical study of plasma thrombin activatable fibrinolysis inhibitor in the patients with stroke

目的研究总凝血酶激活的纤溶抑制物(TAFI)抗原(TAFI∶Ag)和活化的TAFI∶Ag(TAFIa∶Ag)与脑卒中的相关性,探讨二者在缺血性脑卒中(IS)和出血性脑卒中(ICH)的临床意义。方法采用酶联免疫吸附试验(ELISA)对228例脑卒中患者血浆TAFI水平变化进行研究分析,并将IS和ICH分别与对照组比较。结果与对照组[TAFI∶Ag(100.63±25.28)μg/mL;TAFIa∶Ag(126.43±31.88)ng/mL]相比,卒中发作时,2指标在IS[(118.72±31.41)μg/mL,(168.79±55.36)ng/mL]和ICH[(127.51±37.59)μg/mL,(207.99±73.71)ng/mL]均明显升高(P<0.01),并有较高发生率;TAFI评估脑卒中发病风险时,TAFIa∶Ag在IS是对照组的3倍,在ICH是对照组的7倍。结论血浆TAFI与脑卒中存在密切关系,TAFI升高大大地增加了脑卒中的发病风险。

Objective To study the relation of thrombin activatable fibrinolysis inhibitor（TAFI） antigen（ TAFI： Ag） and its activity（ TAFIa： Ag） with stroke, and discuss the clinical significance of them in ischemie stroke（IS） and incerebral hemorrhage（ICH）. Methods The plasma level changes of TAFI were measured in 228 stroke patients by enzyme-linked immunosorbent assay （ELISA） . The levels of TAFI in IS and in ICH were compared respectively with in control. Results The levels of TAFI： Ag and TAFIa： Ag were significantly higher （ P 〈 0. 01 ） in patients with IS （[118.72±31.41] μg/mL,[168.79 ±55.36] ng/mL） and ICH （[127.51 ± 37. 59 ] μg/mL, [ 207. 99 ± 73. 71] ng/mL） as onset than in control（ [ 100.63 ± 25.28 ] μg/mL, [ 126.43 ± 31.88 ] ng/mL） and the incidence rate was higher. For evaluating the risk of stroke with TAFI, the odds rate （OR） for TAFIa： Ag was about 3 times in IS compared with control,and was 7 times in ICH. Conclusions There is close relation between the plasma TAFI and stroke. The risk of stroke increases greatly along with higher TAFI.