凝血、抗凝、纤溶指标检测在进展型脑梗死中的意义

目的通过对比研究进展型脑梗死与完全型脑梗死患者的凝血、抗凝和纤溶系统指标的变化，探讨进展型脑梗死发病机制的特点。方法检测了209例进展型脑梗死患者与209例完全型脑梗死患者的血浆凝血酶原时间（PT）、部分凝血活酶时间（aPTY）、凝血酶时间（TT）、纤维蛋白原（Fbg）、血管性血友病因子（vWF）、血小板聚集率（PAgT）、抗凝血酶活性（AT：A）、抗凝血酶抗原含量（AT：Ag）和组织型纤溶酶激活物活性（t-PA：A）。结果进展型脑梗死患者血浆PT、TT、aPTT显著低于完全型脑梗死患者，而Fbg、PAgT和vWF显著高于完全型脑梗死患者。进展型脑梗死患者AT：A、AT：Ag和t-PA：A水平显著低于完全型脑梗死患者。结论进展型脑梗死患者存在着较高的凝血活性和较低的抗凝和纤溶活性，这是其病情进展的原因之一，临床上可以用凝血、抗凝和纤溶系统功能指标的水平综合判断进展型脑梗死的预后，指导临床抗凝溶栓治疗。

The Study of Coagulant, Anticoagulant and Fibrinolytic Function in Patients of Progressive Cerebral Infarction

Objective In order to early diagnose progressive cerebral infarction and have more time in thrombolytic treatment. The unipue clinical classification and laboratory test of progressive cerebral infarction were discussed. Methods The exploratory research were done in 209 cases progressive cerebral infarction. Prothrombin time (PT), activated partial thromboplastin time (aPTY), thrombin time (TT), fibrinogen (Fbg), yon Willebrand factor (vWF), platelet aggregation test (PAgT), anti-thromhin activity (AT:A), anti-thrombin antigen (AT: Ag), tissue plasminogen activator activity (t-PA: A) in the patients were assayed. Results PT, aPTT and TT in the patients with progressive cerebral infarction were significant shorter than that of patients with complete cerebral infarction. But the concentration of Fbg and vWF in the patients with progressive cerebral infarction were significant higher than that of patients with complete cerebral infarction. PAgT in the patients with progressive cerebral infarction were significant higher than that of patients with complete cerebral infarction. AT:A, AT:Ag and tPA:A in the patients with progressive cerebral infarction. Conclusion The function of coagulation and PAgT in the patients with propessive cerebral infarction were significant stronger than that of patients with complete cerebral infarction. The function of anticoaguation and fibrinolysis in the patients with progressive cerebral infarction were significant lower than that of patients with complete cerebral infarction.