急性脑血栓形成患者血浆及脑脊液纤溶指标的观察

Fibrinolytic Activity in Plasma and Cerebrospinal Fluid in Patients with Acute Cerebral Thrombosis

目的 :研究急性脑血栓形成患者血浆及脑脊液组织型纤溶酶原激活物 (t PA)及其抑制物 (PAI 1)和D 二聚体含量的变化及其临床意义。方法 :采用双抗体夹心固相酶联免疫吸附法 (ELISA)检测 35例急性脑血栓形成患者 (血栓组 )的血浆和其中 31例的脑脊液t PA、PAI 1和D 二聚体的抗原含量 ,与 35例无心脑、肝肾及血液疾病患者 (对照组 )血浆和其中 2 0例脑脊液进行比较。结果 :血栓组血浆及脑脊液中t PA、PAI 1和D 二聚体含量均高于对照组 ;脑脊液中t PA、PAI 1和D 二聚体的含量分别与血浆中含量呈正相关。结论 :急性脑血栓形成患者纤溶活性明显下降 ,t PA及PAI 1参与了脑血栓形成的病理过程。

Objective: To observe the changes in contents of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) and D-dimer antigen in plasma and cerebrospinal fluid from patients with acute cerebral thrombosis respectively and clinical significance. Methods: Plasma contents of t-PA,PAI-1 and D-dimer antigen were determined in 35 patients with acute cerebral thrombosis and in 35 normal control subjects, and cerebrospinal fluid contents of t-PA,PAI-1 and D-dimer antigen were also determined in 31 patients with acute cerebral thrombosis and in 20 normal control subjects. Results:In acute cerebral thrombotic group, the plasma contents of t-PA antigen in patients were higher than those of normal control subjects ( P <0.05); the plasma contents of PAI-1 and D-dimer antigen were significantly higher ( P <0.01). The cerebrospinal fluid contents of t-PA,PAI-1 and D-dimer antigen in the patients with acute cerebral thrombosis were significantly higher than those of normal control subjects; They were positively correlated with plasma contents of t-PA,PAI-1 and D-dimer antigen. Conclusion:The fibrinolytic activity in the patients with acute cerebral thrombosis was significantly lower than normal controls. It suggests that the plasma t-PA, PA-1 and D-dimer might play a role in the pathogenesis of cerebral thrombosis.