脑动脉瘤破裂患者凝血与纤溶系统变化研究

Changes of fibrinolysis system and coagulation in patients with ruptured intracranial aneurysms

目的探讨脑动脉瘤破裂患者凝血与纤溶系统变化规律。方法选取2006-09～2010-01于我院进行治疗的30例脑动脉瘤患者为研究对象,将其根据发病时间分为术前组(A组)、术后即刻组(B组)和术后24h组(C组),后将所有患者三个时期的D-二聚体、t-PA活性、t-PA抗原、PT、APTT、FIB、TT及PAI进行检测及统计比较。结果经研究比较发现,B组PT、APTT、FIB、TT、D-二聚体及PAI与A组比较,P均<0.05,B组PT、APTT、TT及PAI与C组比较,P均>0.05,B组FIB、D-二聚体与C组比较,P<0.05;而B组t-PA活性、t-PA抗原分别与A组及C组比较,均为先升高后下降,P均<0.05,均有显著性差异。结论脑动脉瘤破裂患者随着时间变化凝血与纤溶系统变化较大,应引起重视及进一步研究。

Objective To study the regulation of change of coagulation and fibrinolysis system in the patients with rupture of cerebral aneurysm. Methods Thirty patients with rupture of cerebral aneurysm in our hospital from September 2006 to January 2010 were selected as research subject, and they were divided into preoperative group（group A）, immediate postoperative group（group B）and 24 h after the treatment group（group C） according the onset time, then the levels of D--D, t--pa activity, t --PA antigen,PT,APTT,FIB,TT and PAI of the three periods were tested and compared. Results The levels of PT,APTT, FIB,TT, D--D and PAI of group B were compared to those of group A, P〈0.05. PT,APTT,TT and PAI of group B were compared to those of group C, P〉0.05. FIB and D--D of group B were compared to those of group C, P〈0.05;t--PA activity and t--PA antigen of group B were compared to those of group A and group C, the levels increased first and decreased afterwards, P〈0.05. All differences had statistical significance. Conclusion The changes of coagulation and fibrinolysis system in the patients with rupture of cerebral aneurysm is large with the time changes,and it should be paid attention and studied.