重型颅脑损伤患者血清、脑脊液中t-PA、PAI-1的临床意义研究

Clinical value of determination of t-PA,PAI-1 in serum and cerebrospinal fluid on severe craniocerebral injury patients

目的探讨重型颅脑损伤后的血清及脑脊液中t-PA和PAI-1的变化及临床意义。方法动态观察50例重型颅脑损伤及50例轻型颅脑损伤患者血清及脑脊液中t-PA和PAI-1,进行不同的分组比较分析。结果重型颅脑损伤组脑脊液及血清t-PA、PAI-1在伤后24h、3d、1周、2周和3周均明显高于对照组(P<0.01)。GCS(3～5分)组脑脊液及血清中此2项指标在伤后各阶段明显高于GCS(6～8分)组,两组差异有统计学意义(P<0.01)。重型颅脑损伤预后良好组(n=28例)脑脊液及血清t-PA、PAI-1伤后各阶段均明显低于预后恶劣组(n=22例),两组差异有统计学意义(P<0.05)。结论重型颅脑损伤后t-PA、PAI-1的变化可以反映出脑实质损伤的严重程度,同时与预后呈负相关。临床上通过对重型颅脑损伤患者脑脊液及血清t-PA、PAI-1的检测,可以评估患者病情的严重程度及预后,在临床中有重要意义。

[ Objective] To study the clinical significance and changes of t-PA, PAI-1 in serum and cerebrospinal fluid on severe craniocerebral injury patients. [ Methods ] Enzyme linked immunosorbent assay was utilized to determine t-PA, PAI-I in serum and cerebrospinal fluid on 50 severe craniocerebral injury patients and 50 mild patients. [ Results] The concentration level of t-PA, PAI-1 in serum and cerebrospinal fluid in experimental group was significandy higher than that in contrast group （P 〈0.01） in all stages. In GCS （3-5 scores） group, each index was higher than that of GCS （6-8 scores） group （P 〈0.01）. The concentration level of t-PA, PAI-1 on good prognosis group was significantly lower than that on bad prognosis group of severe cranioeerebral injury patients （P 〈0.05）. [ Conclusions] The changes of t-PA, PAI-I on severe craniocerebral injury patients can reflect disease condition. They were negatively correlative with patients prognosis, and they could be applied to reflect the patient＇s condition and assess prognosis.