脑出血急性期血肿扩大患者血液纤溶活性的研究

Fibrinolytic activity in patients with hematoma enlargement in acute phase of cerebral hemorrhage

目的探讨脑出血患者急性期血液纤溶活性的变化规律和脑出血后血肿扩大与血液纤溶活性的关系。方法利用发色底物法及酶联免疫吸附试验检测115例脑出血患者在发病后6、12、24h血浆纤溶酶原活性（PLG：A）及血浆D-二聚体（D-D）水平，并与50例健康者进行比较。按血肿有否扩大，将115例脑出血患者分为血肿扩大组20例和无血肿扩大组95例，对2组PLG：A及D-D水平进行比较。结果脑出血患者发病后6、12、24h血中PLG：A明显低于对照组，差异有统计学意义（均P〈0．05）；发病后6、12、24h血中D—D显著高于对照组，差异有统计学意义（均P〈0．05）；2组患者发病后6、12、24h血中PLG：A及D-D差异无统计学意义（P均〉0．05）。结论脑出血患者急性期血液纤溶活性升高，脑出血后血肿扩大与血液纤溶活性无明显相关性。

Objective To investigate the changes of plasma fibrinolytic activity of patients in acute phase of cerebral hemorrhage and to evaluate the relationship between fibrinolytic activity and hematoma enlargement. Methods The PLG： A and the plasma D-D levels of 115 patients with cerebral hemorrhage were detected by means of synthetic chromogenie substrate method and enzyme-linked immunosorbent assay （ELISA）. The blood samples were obtained at 6 h, 12 h and 24 h respectively after onset of the disease. All of the pamameters were compared with 50 healthy subjects. Meanwhile 115 patients with cerebral hemorrhage were divided into two groups according to the definition of hematoma enlargement： patients with hematoma enlargement and patients without hematoma enlargement. The parameters of the two groups were compared. Results The PLG： A of patients with cerebral hemorrhage at 6 h,12 h and 24 h after onset were significantly lower than those in control group（P 〈0.05）. The levels of D-D in plasma of patients with cerebral hemorrhage at 6 h , 12 h and 24 h after onset were significantly higher than those in control group（ P 〈 0.05 ）. All of the observing parameters presented no significant difference between patients with hematoma enlargement and patients without hematoma enlargement. Conclusion Fibrinolytic activity of plasma increases and hematoma enlargement has no relation with fibrinolytic activity in acute phase of cerebral hemorrhage.