脑梗死患者急性期血浆纤溶活性变化的研究

目的:探讨脑梗死患者急性期血浆纤溶活性改变与脑梗死发病的相关性。方法:采用酶联免疫吸附双抗体夹心法,对38例脑梗死患者及31例健康对照者血浆组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制剂-1(PAI-1)和纤溶酶-抗纤溶酶复合物(PAP)进行检测,并观察梗死体积对这些指标的影响。结果:脑梗死组急性期血浆PAI-1和PAP水平较对照组明显升高,t-PA水平比对照组降低;梗死体积较大的患者PAP水平明显高于腔隙性梗死者,均有统计学意义(P<0.05)。结论:脑梗死患者血浆t-PA、PAI-1的水平异常,既提示了脑血管内皮细胞的损害,又可能是疾病发生的独立危险因子:血浆PAP的升高则反映了纤溶系统被激活的程度,其临床检测有助于及时对患者进行必要的溶栓和抗凝等治疗。

A Study on the Alteration of Fibrinolyis Markers in the Patients with Acute Cerebral Infarction

Objective: To study the alteration of fibrinolysis markers in the patients with acute phase of cerebral infaction (CI) and its clinical significance. Methods: ELISA method was used to detect the plasma levels of tissue plasminogen activator (t-PA) , plasminogen activator inhibitor-1 ( PAI-1) and plasmin-antiplasmin complex (PAP) in 38 cases of CI patients and 31 normal controls. We also compare fibrinolysis changes in different volume of Cl. Results: Compared with control group, plasma levels of PAI-1 and PAP increased significantly, t-PA decreased obviously in CI group ( P < 0.05). PAP levels increased significantly in subgroup of medium-large volume infarct compared with lacunar infarct subgroup (P < 0.05) . Conclusion: Changes of t-PA, PAI-1 and PAP levels indicated that endothelia of cerebral vessels were impared in CI patients and these might be the risk factors of CI. Measuring PAP in CI may be helpful in treatment of the disease.