脑梗死和脑出血患者凝血和血小板状态的研究

Study of blood coagulation and platelet in cerebral infarction and intracerebral hemorrhage

目的 探讨脑梗死 ,脑出血患者凝血及血小板方面的变化情况。方法 脑梗死患者 4 0例 ,脑出血患者30例 ,正常对照组 35例 ,患者在发病后 72小时内抽肘静脉血抗凝。患者和对照组均未接受任何止血、凝血药物。分析脑梗死患者与健康人 ,脑出血患者与健康人 ,脑梗死患者与脑出血患者 ,大面积脑梗死患者与腔隙性脑梗死患者在凝血酶原时间 (PT)、活化部分凝血酶原时间 (APTT)、凝血酶时间 (TT)、纤维蛋白原 (FIB)、血小板计数 (PLT)、血小板平均体积 (MPV) 6项指标上有无统计学意义。结果 急性脑梗死组与健康人比较 ,FIB和MPV均明显高于对照组(P <0 .0 1)。高血压性脑出血组与健康人比较 ,FIB和MPV均明显高于对照组 (P <0 .0 1)。急性脑梗死组与高血压性脑出血组比较 ,PT ,APTT ,TT ,FIB ,PLT ,MPV 6项指标均无统计学意义 (P >0 .0 5 )。大面积脑梗死组与腔隙性脑梗死组比较 ,PT ,APTT ,TT ,FIB ,PLT ,MPV 6项指标均无统计学意义 (P >0 .0 5 )。结论 血浆纤维蛋白原升高和血小板体积增大是脑梗死的重要危险因素 ,也是脑出血的重要危险因素。脑梗死与脑出血有共同的发病基础。较大血管闭塞引起的脑梗死与腔隙性脑梗死在凝血与血小板状态方面无统计学意义。

Objective To study the changes in coagulation and platelet in cerebral infarction and intracerebral hemorrhage. Methods In this study,40 subjects with cerebral infarction and 30 subjects with intracerebral hemorrhage were diagnosed by CT. In addition, 35 normal persons were made as control group. The patients and the control group had not taken medicine which affects coagulation. Six parameters, PT, APTT, TT, FIB PLT MPV were analyzed to find out the relation between the six parameters and the cerebral attack. Results FIB and MPV in cerebral infarction group were found obviously higher than those in control group (P< 0.01). FIB and MPV in intracerebral hemorrhage group were found obviously higher than those in control group(P< 0.01). FIB,MPV, PT,APTT,TT,PLT were found similar between cerebral infarction group and intracerebral hemorrhage group(P> 0.05). FIB,MPV, PT,APTT,TT,PLT were found similar between bigger area cerebral infarction group and lacunar infarct group (P> 0.05). Conclusions FIB and MPV are higher in cerebral infarction and intracerebral hemorrhage. High level of FIB and MPV are related both to cerebral infarction and intracerebral hemorrhage. Cerebral infarction and intracerebral hemorrhage have same pathological base. Bigger area cerebral infarction and lacunar infarct were found similar in blood coagulation and platelet.