高血压急性缺血性脑血管病的凝血纤溶干预治疗的临床观察

Clinical Observation on Effect of Intervention Therapy with Anticoagulant in Treating Patients of Hypertension Complicated with Acute Ischemic Cerebrovascular Disease

目的 :研究高血压急性缺血性脑血管病 (AICVD)患者经抗凝治疗前后凝血、纤溶及蛋白C系统的反应及临床疗效。方法 :对 57例AICVD患者 ,随机分组后分别给予肝素及血栓通干预治疗 ,两组治疗前后分别测定凝血酶原时间 (PT)、部分凝血活酶时间 (APTT)、纤维蛋白原 (FIB)、组织纤溶酶原激活物(t PA)、组织纤溶酶原激活物抑制剂 (PAI)、活化蛋白C(APC)。结果 :肝素组临床愈显率 69 2 % ,血栓通组愈显率 67 7% ,两组临床疗效比较差异无显著性 (P >0 0 5)。肝素组治疗后PT及APTT均延长 ,FIB水平下降 ,t PA活性增加 ,PAI活性下降 ,APC无显著变化。血栓通组治疗后FIB水平下降 ,t PA活性增加 ,PAI活性下降 ,APC活性增加 ,而PT及APTT无显著变化。结论 :肝素及血栓通对高血压伴缺血性脑卒中的早期治疗均有良好的抗凝及临床疗效。

Objective: To study the changes of blood coagulation fibrinolysis C protein system in patients of hypertension with acute ischemic cerebrovascular disease (AICVD) after anticoagulation therapy. Methods: Fifty seven cases of AICVD were grouped and treated with heparin and Xueshuantong (XST) respectively, and the levels of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), tissue plasminogen activator (t PA), plasminogen activator inhibitor (PAI) and activated protein C (APC) were determined before and after treatment. Results: The clinical markedly effective rate in the heparin group and the XST group was 69.2% and 67.7% respectively with no significant difference (P>0 05). In the heparin group, level of PT and APTT prolonged, FIB decreased, t PA activity elevated and PAI activity lowered, and APC unchanged. In the XST group, same changes in FIB, t PA and PAI were shown but with APC increased, and PT and APTT unchanged. Conclusion: Both heparin and XST have good anticoagulatory function and show good clinical effect in treating patients with hypertension complicated with acute ischemic cerebrovascular diseases.