缺血性脑血管病纤溶活性和血清同型半胱氨酸含量测定的临床意义

目的　探讨缺血性脑血管病 (ICVD)患者血浆纤溶活性和血清同型半胱氨酸 (Hcy)含量的变化及其临床意义。方法　入选ICVD患者 86例 (ICVD组 ) ,根据病情又分为短暂脑缺血发作 (TIA)组 14例 ,脑梗死组 72例 ,并入选非脑血管病患者 4 3例作为对照组 ,分别采用产色法测定血浆纤溶酶原 (Plg)、组织型纤溶酶原激活物 (t PA)、纤溶酶原激活抑制物 1(PAI 1)活性 ,荧光偏振光法测定血清Hcy,电化学发光法测定叶酸 ,同时常规测定血脂水平。结果　ICVD组 ,TIA患者和脑梗死患者血浆Plg、t PA活性均较对照组显著降低 (P <0 .0 5 )。ICVD组血清Hcy水平较对照组明显升高 (P <0 .0 1) ,t PA活性降低和高Hcy对ICVD的发生均有显著作用。结论　t PA活性降低和高Hcy分别是ICVD的独立危险因素

Clinical significance of measuring plasma fibrinolytic activity and homocysteine concentration in ischemic cerebrovascular disease

Objective To investigate the changes of plasma fibrinolytic activity and serum homocysteine concentration in patients with ischemic cerebrovascular disease and their clinical significance.Methods Blood samples were collected from 86 patients with ischemic cerebrovascular disease and 43 controls. Plasminogen, t-PA and PAI-1 activity were determinated by chromogenic substrate assay, homocysteine concentration by fluorescence polarization immunoassay and folacin concentration by electrochemiluminescence.Results Both plasminogen and t-PA activities in patients decreased significantly as compared with controls(P<0.05). PAI-1 activity increased as compared with controls, but it didn't reach statistic significance.Homocysteine concentration in patients increased significantly as compared with controls(P<0.01). Multivariate analysis indicated that both low t-PA activity and high homocysteine concentration played significant roles in ischemic cerebrovascular disease.Conclusion Both low t-PA activity and high homocysteine concentration are important risk factors for ischemic cerebrovascular disease.