溶栓治疗急性脑梗死对纤溶系统的影响

目的　探讨溶栓治疗对纤维系统的影响以及各指标与临床疗效的关系。方法　本研究对９１ 例病后２４ ｈ 内就治的急性脑梗死随机分为４ 组，其中进行血样检测者对照组１４ 例，应用尿激酶（ＵＫ）６×１０５ Ｕ 组２２ 例，１６×１０５ Ｕ 组２２ 例，２６×１０５ Ｕ组１１ 例。在治疗前及治疗后２ ｈ、２４ ｈ、７～１０ 天（ｄ）进行组织型纤溶酶原激活物（ｔＰＡ）、纤溶酶原激活物抑制物（ＰＡＩ）、纤溶酶原（ＰＬＧ）、Ｄ－二聚体（Ｄ－Ｄ）检测。结果　对照组ｔＰＡ、ＰＡＩ、ＰＬＧ、Ｄ－Ｄ在治疗前及治疗后各时期无变化，溶栓治疗组于治疗后２ ｈ ｔＰＡ 及Ｄ－Ｄ明显升高，ＰＡＩ、ＰＬＧ下降。溶栓治疗并发出血的病例，于治疗后２４ ｈＰＡＩ仍明显降低。结论　溶栓治疗病例存在超早期纤维激活，凝血障碍是溶栓治疗并发出血的重要机制

Effects of Thrombolytic Therapy for Acute Cerebral Ischemic Stroke on Fibrinolytic System

Objective To study effects of thrombolytic therapy for acute cerebral ischemic stroke on fibrinolytic system. Methods Plasma activity of tPA PAI PLG D dimer were assayed in 69 patients with acute cerebral infarction in 24 h of stroke (including control group 14 patients who received only neuroprotective treatment. Results The results indicated: tPA PAI PLG and D dimer didn't show any difference at any point during acute stage in control group; tPA and D dimer increased significantly wheas PAI and PLG decreased significantly at 2 h in thrombolyic groups. The patients with hemorrhagic complication sencondary to thrombolytic therapy demonstrated PAI decreasing from 2 h to 24 h . Conclu sion Fibrinolysis was activated at the early stage in patients who received thrombolytic therapy. Disorder of fibrinolitic system was the important factor in hemorrhagic complication sencondary to thrombolytic therapy.