脑梗死患者血纤溶系统活性指标的改变和预后的关系

The relationship between the changes of fibrinolytic activity parameters and prognosis in patients with cerebral infarction

目的 研究脑梗死患者血浆组织型纤溶酶原激活物 (t- PA )及其抑制物 (PAI- 1)水平的改变和预后的关系。方法 对 112例脑梗死患者进行了血浆 t- PA、PAI- 1、血糖、血脂的检测及神经功能缺损程度的评分。分为脑梗死组、再梗死组和正常对照组进行比较 ;并根据神经功能缺损程度的评分分为轻型、中型、重型 3组 ,比较各组间的血浆 t- PA、PAI- 1水平差异及其和预后的关系。结果 脑梗死组、再梗死组的血浆 t-PA、PAI- 1水平与正常对照组相比有显著差异 (P <0 .0 1) ;血浆 t- PA水平与神经功能恢复程度呈明显正相关 ,PAI- 1水平则和它呈明显负相关 ;恢复期再梗死患者血浆 PAI- 1水平高于正常对照组。结论 脑梗死患者病初纤溶活性越低 ,预后越差。再梗死患者恢复期血浆 PAI- 1处于持续高水平状态是脑梗死再发原因之一。

Objective To study the relationship between the changes of tissue type plasminogen activator (t PA),plasminogen activator inhibitor 1 (PAI 1) and prognosis in patients with cerebral infarction.Methods Plasma t PA, PAI 1, blood glucose and blood lipids were determined in 112 patients with cerebral infarction,their neurological functional deficit scores were evaluated.112 patients were divided into cerebral infarction and recurrent cerebral infarction group,and they matched with the controls. According to neurological functional deficit score they were divided into mild, moderate and severe group.The relationship between the difference of t PA,PAI 1 level and prognosis was compared.Results There was obvious difference (P< 0.01 ) between the levels of t PA and PAI 1 in patients with cerebral infarction,recurrent cerebral infarction and the control group.There was a positive correlation between plasma t PA activity and neurological functional recovery de gree,but there was a negative correlation between it and PAI 1 activity. In convalescene, PAI 1 activity of patients with recurrent cerebral infarction was higher than that of the control group.Conclusion In the early stage of cerebral infarction, the lower patients' fibrinolytic system activity was,the poorer prognosis was.Continual high activity of PAI 1 in patients with recurrent cerebral infarction in convalescence might be one of the causes of recurrent cerebral infarction.