急性脑梗死患者血浆纤溶酶原激活物及其抑制剂-1水平的动态变化及其与梗死面积的关系

目的 探讨急性脑梗死患者血浆组织型纤溶酶原激活物(t-PA)及其抑制剂-1(PAI-1)水平的动态变化及其与梗死面积的关系.方法 急性脑梗死患者100例,其中大面积脑梗死22例、小面积脑梗死36例、腔隙性脑梗死42例,采用发色底物显色法检测脑梗死患者病后24 h、2 d、14 d、21 d的血浆t-PA、PAI-1水平,与正常对照组比较;并比较不同面积脑梗死患者血桨t-PA、PAI-1水平.结果 与正常对照组比较,急性脑梗死患者病后24 h、2 d、14 d血浆t-PA水平显著降低,血浆PAI-1水平明显升高(均P＜0.01);病后21 d两者与正常对照组差异无统计学意义(均P＞0.05);大面积脑梗死患者t-PA水平明显低于小面积和腔隙性脑梗死患者,小面积脑梗死患者又明显低于腔隙性脑梗死患者(均P＜0.01);不同面积脑梗死组之间PAI-1水平未见明显差异(均P＞0.05).结论 脑梗死患者急性期血浆t-PA水平降低及PAI水平升高;脑梗死面积越大的患者血浆t-PA水平降低程度越明显,而血浆PAI-1水平与梗死面积无关.

The relationship between the dynamic change of plasma plasminogen activator and its inhibitor-1 levels and infarct size in patients with acute cerebral infarction

Objective To explore the relationship between the dynamic change of plasma tissue-type plasminogen activator(t-PA)and its inhibitor-1(PAI-1)levels and infarct size in patients with acute cerebral infarction.Methods There were 100 patients with acute cerebral infarction,22 cases of large area infarction,36 cases of small area infarction,42 cases of lacunar infarction.The levels of plasma t-PA or PAI-1 in 24 h,2 d,14 d,21 d after cerebral infarction were detected by chromogenic substrate method,compared with normal control and the level of blood plasma t-PA or PAI-1 in patients with different size of cerebral infarction.Results Compared with normal control,levels of plasma t-PA at 24 h,2 d,14 d after acute cerebral infarction decreased significantly,and plasma PAI-1 level increased significantly(all P<0.01).There was no significant difference of the levels of plasma t-PA and PAI-1 at 21 d after onset of acute infarction between the infarction group and controls(all P>0.05).The plasma t-PA level in patients with large size of infarction was lower obviously than that in patients with small area infarction and lacunar infarction,small size of infarction was lower than that in lacunar infarction(all P<0.01).There was no significant difference of the level of plasma PAI-1 in patients with different size of the infarction(allP>0.05).Conclusion The plasma t-PA level decreased and PAI level increased in patients with acute cerebral infarction.The the size of infarction area is larger,the plasma t-PA level is lower,but there is no relationship between the plasma PAI-1 level and infarction area.