凝血功能检测在脑出血患者预后评估中的应用价值

The changes of coagulation function in the prognosis of patients with cerebral hemorrhage

目的探讨凝血功能检测在脑出血患者预后评估中的应用价值。方法选取脑出血患者120例,所有患者入院后行凝血功能检测。根据其与正常值比较的结果分组,有≥3个指标较正常值降低或升高30%以上的患者入研究组,其余入对照组。观察组68例,对照组52例。检测两组患者的凝血功能指标:D-二聚体(D-Dimer)、抗凝血酶Ⅲ(AT-Ⅲ)、血栓调节蛋白(TM)、内皮素-1(ET-1)、纤溶酶原激活剂抑制物-1(PAI-1),分析检测结果与预后的关系。结果观察组的病残率和病死率均比对照组高,差异有统计学意义(P<0.05)。观察组的五项凝血指标变化情况相比对照组更加明显。D-Dimer、ET-1、TM、PAI-1四项指标在入院后48 h即显著升高,与对照组比较,差异有统计学意义(P<0.05)。AT-Ⅲ在入院后48 h则异常降低,与对照组比较,差异有统计学意义(P<0.05)。结论凝血功能检验在脑出血患者的病情评估和预后判断上有应用价值。

Objective To explore the value of coagulation function in the prognosis of patients with cerebral hemorrhage. Methods One hundred and twenty patients with cerebral hemorrhage were randomly selected from our hospital, according to the laboratory indexes of hospitalized patients compared with normal range, patients were classified into 2 groups ： observation group 68 cases, control group 52 cases. We detected the coagulant function indexes of two groups patients, including： D-Dimer, endothelin-1 （ ET-1 ）, thrombomodulin （ TM）, plasminogen activator inhibitor-1 （PAI-1） and antithrombin Ⅲ（ AT- Ⅲ）. Results Compared with control, the observation group had higher disability rate and mortality rate, the differences were significant （P 〈 0. 05 ）. The variation of five coagulation indexes in observation group were more obvious compared with the control group. To compare with control, the plesma D-Dimer, ET-1, TM and PAI-1 increased and AT- Ⅲdecreased significantly in 48 h after attack, the difference were significant （P 〈 0. 05 ）. Conclusion The coagulation function test have some value in the disease assessment and prognosis estimation for cerebral hemorrhage patients.