急性脑梗死患者血小板聚集功能、血管性血友病因子、抗凝血酶及 D-二聚体测定的临床意义

目的：探讨急性脑梗死患者血小板聚集功能（ PAgT）、血管性血友病因子（ vWF）、抗凝血酶（ AT）和D-二聚体（ D-dimer）水平变化及临床意义。方法选用相应的方法和仪器测定112例脑梗死及80例健康对照者血（浆） PAgT、vWF、AT和D-dimer水平变化，同时对部分患者进行治疗前、后的对比分析。结果脑梗死患者血中PAgT、vWF、D-dimer等指标均明显高于健康对照组，AT活性较对照组显著降低，差异有统计学意义（P＜0．05或P＜0．01）。选取经治疗效果明显好转的78例脑梗死患者，出院前取空腹静脉血测定PAgT、vWF、AT、D-dimer等指标，并与治疗前对照，结果治疗后PAgT、vWF、D-dimer降低，AT活性升高，差异有统计学意义（P＜0．05或P＜0．01）。结论脑梗死患者体内存在明显的凝血及纤溶功能异常，与血管内皮损伤、血小板聚集功能增强、凝血及纤溶功能亢进、抗凝功能降低等多因素有关。 PAgT、vWF、AT、D-dimer可以作为脑梗死患者诊断、治疗监测和预后判断的参考指标。

Clinical significance on changes of platelet aggregation test,von Willebrand factor,antithrombin and D-dimer assayin acute cerebral infarction patients

Objective To evaluate the clinical signification of coagulation ,anti-coagulation and fibrinolysis indexes i.e.platelet aggrega-tion test(PAgT),von Willebrand factor(vWF),antithrombin(AT),D-dimer in acute cerebral infarction patients.Methods vWF was as-sayed using ELISA method,AT was determined by chromogenic substances assay,and Latex enhanced immune turbidimetry for D-dimer. vWF,AT and D-dimer all the parameters were finished by SysmexCA-7000 automated blood coagulation analyzer.PAgT was measured sim-ultaneously using a whole-blood Lumi-Aggregometer by CHRMNO-LOG platelet aggregation apparatus.Results PAgT, vWF, D-dimer were significantly higher in acute cerebral infarction patients group,compared with those in the control group(P<0.05 or P<0.01). while AT was significantly lower(P<0.05).After effective treatment,PAgT,vWF,AT,D-dimer Indicators are all improved.Conclusion There is significant abnormal in coagulation,anti-coagulation and fibrinolysis system in acute cerebral infarction patients.PAgT,vWF, AT,D-dimer can be as good predictors for the blood coagulation fibrinolysis imbalance state of the disease and the degree of recovery.