急性脑梗死患者血小板聚集功能、血管性血友病因子、抗凝血酶及D-二聚体测定的临床意义

Clinical significance on changes of platelet aggregation test,von Willebrand factor,antithrombin and D-dimer assayin acute cerebral infarction patients

目的探讨急性脑梗死患者血小板聚集功能(PAg T)、血管性血友病因子(v WF)、抗凝血酶(AT)和D-二聚体(D-dimer)水平变化及临床意义。方法选用相应的方法和仪器测定112例脑梗死及80例健康对照者血(浆)PAg T、v WF、AT和D-dimer水平变化,同时对部分患者进行治疗前、后的对比分析。结果脑梗死患者血中PAg T、v WF、D-dimer等指标均明显高于健康对照组,AT活性较对照组显著降低,差异有统计学意义(P<0.05或P<0.01)。选取经治疗效果明显好转的78例脑梗死患者,出院前取空腹静脉血测定PAg T、v WF、AT、D-dimer等指标,并与治疗前对照,结果治疗后PAg T、v WF、D-dimer降低,AT活性升高,差异有统计学意义(P<0.05或P<0.01)。结论脑梗死患者体内存在明显的凝血及纤溶功能异常,与血管内皮损伤、血小板聚集功能增强、凝血及纤溶功能亢进、抗凝功能降低等多因素有关。PAg T、v WF、AT、D-dimer可以作为脑梗死患者诊断、治疗监测和预后判断的参考指标。

Objective To evaluate the clinical signification of coagulation ,anti-coagulation and fibrinolysis indexes i.e.platelet aggrega-tion test（PAgT）,von Willebrand factor（vWF）,antithrombin（AT）,D-dimer in acute cerebral infarction patients.Methods vWF was as-sayed using ELISA method,AT was determined by chromogenic substances assay,and Latex enhanced immune turbidimetry for D-dimer. vWF,AT and D-dimer all the parameters were finished by SysmexCA-7000 automated blood coagulation analyzer.PAgT was measured sim-ultaneously using a whole-blood Lumi-Aggregometer by CHRMNO-LOG platelet aggregation apparatus.Results PAgT, vWF, D-dimer were significantly higher in acute cerebral infarction patients group,compared with those in the control group（P〈0.05 or P〈0.01）. while AT was significantly lower（P〈0.05）.After effective treatment,PAgT,vWF,AT,D-dimer Indicators are all improved.Conclusion There is significant abnormal in coagulation,anti-coagulation and fibrinolysis system in acute cerebral infarction patients.PAgT,vWF, AT,D-dimer can be as good predictors for the blood coagulation fibrinolysis imbalance state of the disease and the degree of recovery.