凝血和抗凝及纤溶功能改变在进展型脑梗死患者中的临床意义

目的研究进展型脑梗死患者凝血、抗凝和纤溶系统功能指标的变化,探讨进展型脑梗死的发病机制,为其临床早期诊断和治疗提供依据。方法对比检测了209例进展型脑梗死患者与209例完全型脑梗死患者血浆凝血酶原时间、凝血酶时间、部分凝血活酶时间、纤维蛋白原、血小板聚集率、血管性血友病因子含量、抗凝血酶、组织型纤溶酶原激活物及纤溶酶原激活物抑制剂-1活性水平。结果与完全型脑梗死患者比较,进展型脑梗死患者的血浆凝血酶原时间、凝血酶时间、部分凝血活酶时间显著缩短,抗凝血酶、组织型纤溶酶原激活物水平显著降低,而纤维蛋白原、血小板聚集率、血管性血友病因子、纤溶酶原激活物抑制剂-1水平显著升高(P<0.01)。结论进展型脑梗死患者存在着明显的高凝血和较低的抗凝和纤溶活性。

Coagulation, anticoagulation and fibrinolytic function changes in patients with progressive cerebral infarction

Objective To early diagnose progressive cerebral infarction and have more time in thrombolytic treatment,and to discuss.the unique clinical classification and laboratory test of progressive cerebral infarction.Methods The exploratory research was done in 209 cases with progressive cerebral infarction.Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib),von Willebrand factor(vWF),platelet aggregation test(PAgT),anti-thrombin activity(AT),tissue-type plasminogen activator (t-PA) and its inhibitor(PAI-1) in the patients were assayed.Results PT,APTT,TT,AT-A and(t-PA) in the patients with progressive cerebral infarction were significant shorter or less than that in patients with complete cerebral infarction. But the concentration of Fib,vWF,PAgT and PAI-1 in the patients were significant higher than that in patients with complete cerebral infarction.Conclusion The function of anticoagulation and fibrinolysis in the patients with progressive cerebral infarction are significantly lower than that in patients with complete cerebral infarction.