脑梗死患者止凝血系统功能改变的研究

目的探讨脑梗死患者治疗前后D-二聚体（D-Dimer）、抗凝血酶活性（AT1A）、组织型纤溶酶原激活物（t—PA）、纤溶酶原激活物抑制物-1（PAI-1）及血管性血友病因子（vWF）的变化趋势，评估上述指标在脑梗死治疗监测中的临床价值。方法采用SYSMEXCA7000型血液凝固仪测定血浆D-Dimer、tPA、PAI-1和AT1A；采用ELISA法测定vWF。结果与健康对照组比较，脑梗死患者组治疗前D-Dimer、PAI-1、vWF显著增高（P〈0．01），t-PA显著降低（P〈0．01），AT：A无显著性改变（P〉0．05）。脑梗死患者治疗后血浆D-Dimer、PAI-1、vWF较治疗前显著降低（P〈0．01），tPA显著增高（P〈0．01），AT：A在治疗前后无明显改变（P〉0．05）；GCS〉8分组和GCS≤8分组血浆胁Dimer、PAI-1、vWF明显下降（P〈0．01），t-PA显著增高（P〈0．01），而AT：A无明显差异（P〉0．05）。结论纤溶系统指标和vWF在脑梗死患者治疗前后发生显著改变且与病程发展相关。

To study On the functional change of thrombosis and haemostasis system in patients with cerebral infarction

Objective To investigate the change trend for D-dimer,antithrombin activity (AT:A),tissue plasminogen activator(t-PA),plasminogen activator inhibitor-1 (PAI-1)and yon Willebrand factor (vWF) before and after treatment in patients with cerebral infarction,so as to evaluate the clinical value of the above parameters in therapeutic effect monitoring of cerebral infarction.Methotis SYSMEX CA7000 blood coagulation analyzer was applied to determining plasma D-dimer,t-PA,PAI-1 and AT:A,and ELISA was adopted to measure vWF.Results Compared with those of healthy control group,D-dimer,PAI-1 and vWF were significantly increased (P<0.01),t-PA was significantly decreased (P<0.01),and AT:A had no change (P>0.05) in cerebral infarction group before treatment.In cerebral infarction group,compared with those of pre-treatment,D-dimer,PAI-1 and vWF were significantly decreased (P<0.01),t-PA was significantly increased(P<0.01),and AT:A had no change(P>0.05) after treatment.So was the situation between GCS>8 and GCS≤8group.Conclusion There are obvious changes of fibrinolytic system parameters and vWF level befor and after treatment in patients with cerebral infarction,and the changes are associated with the course of disease.