急性期脑出血中组织因子途径抑制物、组织因子、纤维蛋白原、D-二聚体、超敏C反应蛋白的浓度及凝血因子Ⅶ所致的变化

Concentrations of tissue factor pathway inhibitor-1,tissue factor,fibrinogen,D-dimer,hypersensitive C-reactive protein,and differences caused by coagulation factor Ⅶ in acute stage of intracranial hemorrhage

目的：分析脑出血（ICH）患者组织因子途径抑制物（TFPI-1）、组织因子（TF）、纤维蛋白原（FIB）、D-二聚体、超敏C反应蛋白（hs-CRP）及凝血因子VII（FVII：C）的变化,为早期诊断ICH提供更多的实验依据。方法：随机抽取53例ICH患者及50例体检健康者,分别作为ICH组和正常对照组。采用双抗夹心酶联免疫吸附法测定两组血清中的TFPI-1、TF、FIB、D-二聚体、hs-CRP浓度;采用一期凝固法检测FVII：C（%）;统计分析ICH组与正常对照组间的差异及三者（FIB、D-二聚体、hs-CRP）单检和联检对ICH的诊断效能。结果：ICH组的TFPI-1、TF、FIB、D-二聚体、hs-CRP浓度及FVII：C均高于对照组,差异有统计学意义（P〈0.01）。血清FIB、D-二聚体及hs-CRP诊断ICH的受试者工作特征（ROC）曲线下面积分别为0.85（95%CI：0.720～0.980）、0.87（95%CI：0.731～0.970）及0.76（95%CI：0.590～0.930）,三者联合检测诊断ICH的ROC曲线下面积为0.89（95%CI：0.760～0.980）。FIB、D-二聚体、hs-CRP三者联合检测的诊断灵敏度和特异度（89.5%、90.0%）较三者单检高（94.7%、75.0%）、（84.2%、90.0%）、（73.7%、89.1%）。结论：TFPI-1、TF、FIB、D-二聚体、hs-CRP水平及FVII：C与ICH的发生、发展有关;FIB、D-二聚体、hs-CRP三者联合检测可以提高诊断灵敏度和特异度。

Objective To provide more laboratory evidence for early diagnosis of intracranial hemorrhage（ICH） by analyzing the concentrations of tissue factor pathway inhibitor-1（TFPI-1）, tissue factor（TF）, fibrinogen（FIB）, D-dimer, hypersensitive Creactive protein（hs-CRP）, and differences caused by coagulation factor VII（FVII：C）. Methods Totally, 53 ICH patients and 50 healthy persons were randomly selected and respectively taken as ICH group and normal control group. The concentrations of serum TFPI-1, TF, FIB, D-Dimer, hs-CRP in the two groups were detected by double-antibody sandwich enzyme-linked immuno sorbent assay; the activity of plasma F VII：C was detected by a one-stage clotting assay; the differences between the two groups,and the diagnosis efficiencies of single detection（FIB, D-Dimer, hs-CRP） and combined detection were statistically analyzed.Results The concentrations of TFPI-1, TF, FIB, D-Dimer, hs-CRP and FVII：C in ICH group were significantly higher than those in normal control group, with statistically significances（P〈0.01）. The area under the receiver operating characteristic（ROC）curve of serum FIB, D-Dimer and hs-CRP for the diagnosis of ICH were respectively 0.85（95% CI： 0.720-0.980）, 0.87（95%CI： 0.731-0.970） and 0.76（95% CI： 0.590-0.930）. The area under the ROC curve of combined detections for the diagnosis of ICH was 0.89（95% CI： 0.760-0.980）. The sensitivity and specificity of detection combined FIB, D-Dimer and hs-CRP were respectively 89.5%, 90.0%, higher than those of three single detections which were respectively（94.7%, 75.0%）,（84.2%, 84.2%）,（73.7%, 89.1%）. Conclusion The concentrations of TFPI-1, TF, FIB, D-Dimer, hs-CRP and FVII：C are associated with the development of ICH. And the detection combined FIB, D-Dimer and hs-CRP improves the sensitivity and specificity.