F1+2、TAT和D-二聚体在急性脑梗死溶栓治疗中的应用研究

To observe the dynamic data of F1+2、TAT、D-D in patients with acute cerebral infarction treated with Urokinase

目的 探讨急性脑梗死溶栓治疗前后血中凝血酶原片段 1+2 (F1+2 )、凝血酶 抗凝血酶 复合物 (TAT)和D 二聚体 (D D)的动态变化及临床意义。方法 对 2 1例急性脑梗死患者 (均于6h内接受溶栓治疗 )溶栓前及溶栓后 2、4、6、8、2 4、4 8h血标本采用酶联免疫吸附双抗体夹心法(ELISA)测定F1+2、TAT、D D水平。其中有效组 (n =14 ) ,无效组 (n =7) ,并与正常对照组 (n =2 2 )进行比较。结果 患者组治疗前与正常对照组相比F1+2、TAT、D D差异均有显著意义 (P <0 0 5 )。溶栓后有效组 2hF1+2、D D水平达到峰值 ,2h后D D水平迅速下降 ,但 4 8h仍然高于治疗前水平 3倍以上。无效组F1+2、TAT持续缓慢上升 ,D D 4～ 6h低于有效组 ,但 3项指标 2 4h均达到峰值。结论 急性脑梗死溶栓治疗前后F1+2、TAT、D D水平变化对判断疗效有一定指导意义。

Objective To explore the dynamic data of F1+2 and TAT and D-dimer during the thrombolysis treatment with Urokinase.Methods Observe the dynamic data of D-Dimer(D-D), thrombin antithrombin Ⅲ complex (TAT), prothrombin fragment F1+2 (F1+2) in the vein blood of 21 patients with acute cerebral infarction before and at 2、4、6、8、24、48 h after treatment with Urokinase. In these patients, there are effective group (n=14) and noneffective group (n=7), which compared with normal control group (n=22). Results The control group compared with the patients before treatment, D-Dimer、TAT、F1+2 were significantly different (all P<0.05). In effective group, after treatment with Urokinase, D-Dimer、F1+2、TAT levels reached peak at 2 h, then D-D levels decreased quickly, but 3 times higher than the levels before treatment at 48 h. In noneffective group, F1+2、TAT slowly increased, D-D levels were lower than levels of effective group at 4 h and 6 h, but the three marks reached peak at 24 h.Conclusions The diversified levels of F1+2、TA and D-Dimer before and after treatment in acute cerebral infarction patients have some extent instructive significance to diagnosis and treatment of the acute cerebral infarction.