脑梗死患者凝血和纤溶机制的研究

目的　探讨脑梗死患者急性期、亚急性期和恢复期血浆纤维蛋白原、D -二聚体 (D -D)、组织型纤溶酶原激活物 (t -PA)和纤溶酶原 (PLG)含量的变化及意义。方法　对 60例脑梗死患者急性期、亚急性期和恢复期纤维蛋白原、D -D、t -PA、PLG的水平进行测定 ,并与 2 5例健康对照者进行比较。结果　纤维蛋白原和D -D的含量在 3阶段均高于对照组 (P <0 0 1) ,且升高的程度与梗死的体积有一定的关系 ;纤维蛋白原的含量在 3个阶段无明显统计学差异 (P >0 .0 5 ) ,而D -D在亚急性期显著升高 (P <0 .0 5 ) ,恢复期开始下降。T -PA和PLG于急性期时 ,t-PA血浆水平高于对照组 (P <0 .0 1) ,PLG则低于对照组 (P <0 .0 1)。结论　脑梗死患者在发病后存在凝血 -纤溶系统的紊乱

Blood coagulation and fibrinolytic activity in patients with acute cerebral infarction

Objective To explore the concentration changes and clinical significance of fibrinogen, D dimer, t PA, and PLG in plasma in patients with acute cerebral infarction during acute, subcute and recovery stages. Methods Sixty patients with acute cerebral infarction were chosen. The concentration of D dimer and t PA in plasma was measured by enzyme linked immunosorbent assay (ELISA) and the PLG biological activity was measuredby chromophore method. The concentration of fibrinogen was measured by Clause method. All these results were compared with 25 control subjects. Results Theconcentration of fibrinogen and D dimer was higher in patients than in normalsubjects( P <0.01)in three different stages and the increased extent was correlated with infarction volume. Moreover the concentration of fibrinogen amongthree stages was not different( P >0.05)and the concentration of D dimer was the highest during subacute stage( P <0.05). The concentration of t PAwas significantly higher in patients than in normal subjects( P <0.01),while the PLG activity was lower( P <0.01)during acute stage. Conclusion The disorder of the coagulation and fibrinolytic system exists in patients with cerebral infarction. These hematological markers have clinical significance.