脑血管病患者血小板、纤溶活性、内皮细胞合成物测定的意义

目的：探讨血浆中血栓素 Ｂ_２（ＴＸＢ_２），血小板α颗粒胰蛋白－１４０（ＧＭＰ－１４０）， ６－酮前列腺素１α（６－Ｋ－ＰＧＦ１α），内皮素（ＥＴ）、组织型纤溶酶原激活剂（ｔＰＡ）、纤溶酶原激活剂抑制物（ＰＡＩ）活性，在脑动脉硬化、脑血栓发病过程的作用及临床意义。方法：ＴＸＢ_２、Ｇｍｐ－１４０、６－Ｋ－ＰＧＦ１α、ＥＴ采用放射免疫法（ＲＩＡ）、ｔＰＡ、ＰＡＩ采用发色底物法分别测定脑动脉硬化，脑血栓和正常对照组的含量，并进行分析。结果：①脑动脉硬化组，脑血栓组血小板指标ＴＸＢ_２，ＧＭＰ－１４０水平明显高于正常组（Ｐ均＜０．０１）；②内皮细胞合成物６－Ｋ－ＰＧＦ１α、ＥＴ含量脑血栓组明显低于和高于正常组（Ｐ均＜０．０１），脑动脉硬化组无明显差异（Ｐ均＞０．０５）。 ③纤溶指标 ｔＰＡ， ｔＰＡ／ＰＡＩ两组脑血管病血浆水平明显低于正常组。 ＰＡＩ水平虽有增高，但无明显差异（Ｐ＞０．０５）。结论：脑血管疾病存在血小板活化，内皮细胞受损、纤溶活力低下，这些改变可能参与此二类疾病发病过程。故须针对以上改变对患者采用相应治疗措施。

THE CLINICAL SIGNIFICANCE OF PLASMA PLATELET PLASMINOGEN ACTIVATE ENDOTHELIAL SYNTHESIN LEVELS IN PAFIENTS WITH CEREBROVASCULAR DESEASE

Objective: To study the effects and clinical significance of plasmal thromboxane B_2 (TXB_2), platelet alpha granule membrance protein-140 (GMP-140), 6-Keto-PGF1a (6-K- PGF1α), endothelins(ET), tissue type plasminogen activator(tPA)and plasmingen activator inhibitor-1 PAI-1) in patients with cerebral arteriosclerosis and cerebral thrombosis. Methods: Plasma TXB_2, GMP 140, 6-K-PGF1 α and ET levels were determined by radioimmunoassay. Plasma tPA and PAI were determined by the chromogenic peptide substrate method in controls and in patients with cerebral arteriosclerisis and cerebral thrombosis. Results: ①The levels of plasma TXB_2 and GMP-140 were significantly higher in patients with cerebral arteriosclerisis and cerebral thrombosis than in the control group(P<0.01). ② The level of 6-K-PGF1α was higher and the level of ET was lower in patients with cerebral thrombosis than in the controls(P<0.01), while in the levels of 6-K-PGF1α and ET but no difference was found in patients with cerebral arteriosclerisis compared with controls(P>0.05). ③ The levels of tPA and tPA/PAI were significantly lower in patients with cerebral arteriosclerise and cerebral thrombosis than in controls. Although the PAl level increased in patients with cerebral arteriosclerise and cerebral thrombosis, no difference was found in statistics. Conclusion: Activation of platelets, injury of endothelial cell and decreased activity of fibrinolysis in patients with cerebrovascular disease may be involved in the development of these diseases. Appropriate treatment should be adopted targettd on the above abnorrnality.