脑室出血时脑脊液中尿激酶型纤溶酶原激活物受体的动态变化及意义

Dynamic changes and significance of Urokinase plasminogen activator receptor （ UPAR ） in cerebrospinal fluid of intraventricular hemorrhage patients

目的探讨脑室出血后脑室系统是否存在纤溶系统活性物质基础，应用外源性尿激酶（UK）是否有助于增强纤溶的活性。方法34例脑室出血经侧脑室穿刺外引流治疗的患者随机分为UK组和non—UK组。UK组均行侧脑室穿刺＋脑室内UK灌注治疗；而non—UK组单纯行侧脑室穿刺外引流治疗。留取穿刺后0、2、4、6、12h脑室外引流脑脊液标本2mL，采用ELISA法测量每组各时间点脑脊液标本中尿激酶型纤溶酶原激活物受体（UPAR）水平。结果non—UK组脑室出血后6～24h、24～48h、48～72h三个时间段脑脊液中UPAR水平比较差异无统计学意义。UK组经脑室穿刺注入UK2h后脑室外引流脑脊液中UPAR水平增高。结论脑室出血后脑室系统中存在纤溶系统活性物质基础，在脑室出血后的脑室系统内应用UK是可行的。

Objective To study the dynamic changes of Urokinase plasminogen activator receptor （UPAR） in cerebrospinal fluid （ CSF） of intraventricular hemorrhage （IVH） patients who received whether an intraventricular infusion of Urokinase or not, and to answer two questions： One was whether the fibrinolytie ability existed in ventricular systems after IVH＇; and the other was whether the fibrinolytic activity of ventricular system was actually enhanced after intraventricular infusion of Urokinase. Methods 34 severe IVH patients with the treatment of external ventricular drainage （ EVD ） were randomly divided into two groups, UK group and non - UK group. In UK group, all the patients were treated with EVD and intravcntricular infusion of Urokinase, but in non - UK group, the patients with EVD alone. The CSF samples were obtained at 0, 2, 4, 6 and 12 h after EVD operation. Results In non - UK group, there were no significant differences in the UPAR contents of CSF at three periods of 6 -24 h, 24 -48 h, 48 -72 h. Compared with 0 h, the contents of UPAR in CSF were significant higher in UK group. Conelusion The content of UPA＇R in CSF of IVH patients could be measured, which shows that there actually is a substance with fibrinolytic activity in ventricular system after IVH. The contents of UPAR increase in CSF after IVH and could be enhanced by an intraventricular infusion of Urokinase, which suggest ＇s that it is feasible to treat IVH patients with intraventricular infusion of Urokinase.