不同剂量重组组织纤溶酶原激活剂静脉溶栓对急性脑梗死后凝血指标的影响

The coagulation-related indicators observation of different doses of recombinant tissue plasmiogen activator in the treatment of acute cerebral infarction

目的:观察不同剂量重组组织纤溶酶原激活剂(rt-PA)对急性脑梗死静脉溶栓后纤维蛋白原、纤维蛋白降解产物、D-二聚体等凝血指标的影响。方法:选择80例发病后7 h静脉溶栓的急性大脑中动脉供血区脑梗死患者,随机分为rt-PA 0.8 mg/kg和0.9 mg/kg静脉溶栓治疗组各40例。分别在溶栓前、溶栓后2 h,溶栓后24 h静脉采血,观察2组纤维蛋白原、纤维蛋白溶解产物、D-二聚体、凝血因子ⅩⅢ、α2-抗纤溶酶、纤溶酶原和血小板水平。结果:rt-PA 0.8 mg/kg组和0.9 mg/kg组患者纤维蛋白原、纤维蛋白溶解产物、D-二聚体、凝血因子ⅩⅢ、α2-抗纤溶酶、纤溶酶原和血小板水平差异均无统计学意义(P>0.05)。结论:rt-PA 0.8 mg/kg组和0.9 mg/kg组患者溶栓后凝血指标均无明显不同;脑梗死患者可考虑推荐使用rt-PA0.8 mg/kg为药物使用的单位计量。

Objective： To observe the change of coagulation-related indicators levels （ fibrinogen, fibrin degradation products and D- dimer） of different doses of recombinant tissue plasmiogen activator（rt-PA） in the treatment of acute cerebral infarction in middle cerebral artery zone. Methods ： Eighty patients with acute cerebral infarction were treated with intravenous thrombolysis after 7 hours, and randomly divided into rt-PA 0.8 mg/kg and rt-PA 0.9 mg/kg group （40 cases each group）. The levels of coagulation-related indicators（including fibrinogen,fibrin degradation products,D-dimer,clotting factor X Ⅲ ,α2-antiplasmin,plasminogen and platelet） in two groups were observed at 2 hours before thrombolysis and at 2 and 24 hours after thrombolysis. Results：The level differences of fibrinogen, fibrin degradation products, D-dimer, clotting factor X Ⅲ ,α2-antiplasmin, plasminogen and platelet in two groups were not statistical significance （ P 〉 0. 05 ）. Conclusions： There is no evident difference in the coagulation-related indicators between two groups, the 0.8 mg/kg can be selected to treat acute cerebral infarction.