110例静止性脑梗死患者血管内皮损伤及凝血、抗凝血指标的变化

Changes of homocystine,endothelieal cell damage,blood coagulation and anticoagulation indexes in patients with silent cerebral infarction

目的观察静止性脑梗死(SCI)患者血浆同型半胱氨酸(Hcy)、血管内皮损伤及凝血、抗凝血指标的变化。方法年龄大于或等于50岁的110例SCI患者和50例对照组,抽取空腹静脉血,分别检测血浆Hcy、血管性血友病因子(vWF)、凝血酶原时间(PT)、活化部分凝血时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、凝血酶原活性(PA)、凝血酶活性(TA)、抗凝血酶Ⅲ活性(AT-Ⅲ:A)和血浆蛋白C活性(PC:A)等。结果SCI组患者血浆Hcy〔(14.42±4.90)μmol/L〕显著高于对照组〔(9.79±2.51)μmol/L〕;血浆vWF水平〔(128.36±28.92)%〕显著高于对照组〔(68.29±27.37)%〕,P<0.001;APTT和TT较对照组明显缩短(P<0.001),而PT两组间差异无统计学意义(P>0.05);FIB含量明显高于对照组(P<0.001);PA和TA明显高于对照组,而AT-Ⅲ和PC活性则显著低于对照组(P<0.001)。结论血浆Hcy、血管内皮损伤及凝血、抗凝血系统功能失调等异常改变是SCI发生的危险因素。

Objective To study the changes of homocystine（Hcy）, endothelieal cell damage,blood coagulation and anticoagulation indexes in the patients with silent cerebral infarction （SCI）. Methods Hey was determined by fluorometry in 110 patients with SCI and 50 cases over 50 years old in control group. The enzyme linked immunosorbent assay （ELISA） was used to determine the serum level of yon Willebrand factor （vWF）. The prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, fibrinogen （FIB）, prothrombin activity （PA）, thrornbin activity （TA）, antithrombin Ⅲ activity （AT- Ⅲ ： A） and protein C activity （PC：A） were also measured in both groups. Results Compared with the control group,the levels of Hcy and vWF were significantly higher in the patients with SCI（P〈0. 001）. APTT and TT were markedly shorter in SCI group than those in the control group（P〈0. 001）, but PT had no significant difference between the two groups （P〉0.05）. The concentration of FIB was significantly higher in SCI group than that in the control group （P〈0. 001）. PA and TA were significantly increased, but the activities of AT-Ⅲ and PC were markedly decreased as compared with those in the control group （P〈0. 001）. Conclusion Hcy,endothelieal cell damage and hypercoagulation states caused by coagulation and anticoagulation dysfunction are risk factors of SCI.