亚低温对大面积脑梗死患者血浆组织型纤溶酶原激活物和纤溶酶原激活物抑制物-1的影响

Effect of mild hypothernia on plasma tissue-type plasninogen activator/ plasminogen activator inhibitor-1 in patients with massive cerebral infarction

目的探讨亚低温治疗对大面积脑梗死（massivecerebralinfarction，MCI）患者血浆组织型纤溶酶原激活物（tissue-typeplasminogen activator，tPA）和纤溶酶原激活物抑制物-1（plasminogenactivatorinhibitor-1，PAI-1）的影响。方法MCI患者随机分为常规治疗组和亚低温治疗组，后者在常规治疗基础上在人院后立即接受局部亚低温治疗48h。分别于入院时和亚低温治疗48h时采用酶联免疫吸附法检测血浆tPA和PAI-1。比较两组一般资料以及治疗前、后血浆tPA和PAI-1水平。结果共纳入46例患者，其中常规治疗组26例，亚低温治疗组20例。两组患者治疗前一般临床资料以及tPA[（134．5±45．7）pg／ml对（132．7±40．3）pg／ml；t=-0．752，P=0．481]和PAI-1[（206．4±42．3）p髫州对（207．0±42．0）pg／ml；t=0．642，P=0．745]均无显著差异，而亚低温治疗组在亚低温治疗48h时血浆tPAI（80．98±34．64）pg／ml对（110．1±32．7）pg／ml；t=3．462，P=0．013]和PAI-1[（145．40±45．29）pg/ml对（174．2±38．0）pg／ml；t=4．854，P=0．034]水平均显著低于常规治疗组。结论亚低温治疗能降低MCI患者血浆tPA和PAI-1水平，可能与低温治疗的神经保护作用有关。

Objective To investigate the effect of mild hypothermia therapy on plasma tissue-type plasminogen activator （tPA）/plasminogen activator inhibitor-1 （PAI-1） in patients with massive cerebral infarction （MCI）. Methods The patients with MCI were randomly divided into the conventional therapy group and the mild hypothermia therapy group. On the basis of conventional therapy, the latter received local mild hypothermia therapy for 48 hours immediately after admission. Enzyme-linked immunosorbent assay was used to detect plasma tPA and PAI-1 at admission and at 48 hours after mild hypothermia, respectively. The general information and the tPA and PAI-1 levels before and after treatment in both groups were compared. Results A total of 46 patients with MCI were included. There were 26 and 20 patients in the conventional therapy group and the mild hypothermia therapy group, respectively. There were no sigtificant differences in the general information, the tPA and PAI-1 levels before and after treatment in both groups, and the levels of plasma tPA （80. 98 ±34. 64 pg/mL vs. 110. 1 ±32. 7 pg/mL; t =3. 462, P =0. 013） and PAI-1 （145.40±45.29 pg/mL vs. 174. 2 ±38. 0 pg/mL; t =4. 854, P =0. 034） at 48 hours of rnild hypothermia therapy in the mild hypothermia therapy group were sigaificantly lower than those in the conventional therapy group. Conclusions Mild hypothermia therapy may decrease the plasma tPA and PAI-1 levels in patients with MCI, and it may be associated with the neuroprotective effect of hypothermia therapy.