脑梗死合并下肢深静脉血栓形成的病因探讨

目的探讨脑梗死合并下肢深静脉血栓形成(LDVT)的主要发病原因。方法分析50例脑梗死合并LDVT患者(脑梗死合并LDVT组)的临床特点及血液凝血、抗凝和纤溶系统分子标记物指标的变化,另选50例健康体检者为对照组。结果50例脑梗死合并LDVT组患者中,卧床2~4周的发病率最高;伴发疾病中以高血压、血脂异常最常见;与对照组比较,脑梗死合并LDVT组患者的血管性血友病因子、血小板表面α颗粒膜蛋白、凝血酶原片断1+2含量、纤溶酶原激活物抑制剂-1活性均明显升高,而抗凝血酶活性、总蛋白S含量、蛋白C活性、纤溶酶原活性均明显降低,差异有显著性意义。结论长期卧床及血液的高凝状态是LDVT发生的主要原因。

The etiological analysis of cerebral infarction with deep vein thrombosis in lower limb

Objective To investigate the mechanism of cerebral infarction with deep vein thrombosis in lower limb(LDVT).Methods Fifty cases of cerebral infarction with LDVT were selected and 50 healthy men were included in the control group.Analysis was made on their clinical manifestations and molecular markers of coagulant,anticoagulant and fibrinolytic parameters.Results Among 50 cases of cerebral infarction with LDVT,the LDVT occurrence rate was high in the patients who lay on bed over 2～4 weeks or were complicated with other diseases,such as hypertension and abnormal blood lipids.The serum levels of von Willebrand factor(vWF),platelet surface α granule membrane protein(GMP-140),prothrombin fragments 1+2(F1+2) and plasminogen activator inhibitor-1(PAI-1) in the deep vein thrombosis in lower limb group were significantly increased compared with those in the controls.The serum levels of antithrombin(AT),protein S(PS),protein C(PC) and plasminogen(PLg) in the deep vein thrombosis in lower limb group were significantly decreased compared with those in the controls(P<0.01).Conclusion Long-term lying on bed and hypercoagulation are the major etiology.