血小板参数和凝血指标与溶栓治疗关系的探讨

目的 动态观察急性脑梗死患者溶栓治疗过程中血小板参数及凝血指标的变化规律,探讨血小板参数和凝血指标与溶栓治疗的关系.方法 应用血细胞分析仪检测180例急性脑梗死患者（实验组）和180例健康体检者（对照组）的血小板计数（PLT）、血小板平均体积（MPV）和大血小板比率（P-LCR）,血凝分析仪检测凝血酶原时间（PT）、部分活化凝血活酶时间（APTT）、纤维蛋白原（Fg）及凝血酶时间（TT）,动态观察溶栓前及溶栓后1、2、4小时和48小时血小板参数和凝血指标的变化.结果 溶栓前脑梗死患者的MPV、P-LCR和Fg含量均高于对照组（P均＜0.05）,PLT、PT和APTT显著低于对照组（P均＜0.05）;溶栓治疗后,MPV、P-LCR和Fg含量显著下降,PLT、PT和APTT显著升高（P均＜0.05）.结论 溶栓治疗过程中,动态监测急性脑梗死患者的血小板参数（PLT、MPV和P-LCR）和凝血指标（PT、APTT、Fg）,可反映患者凝血功能的变化,对脑梗死患者的溶栓治疗具有一定的参考价值.

Investigation of the relationship between platelet parameters and coagulation markers of patients with acute cerebral infarction during thrombolysis

Objective To dynamically monitor the platelet parameters and coagulation markers of patients with acute cerebral infarction during thrombolysis treatment, and study the relationship between these changes and thrombolysis treatment. Method Platelets （ PLT）, mean platelet volume （ MPV ） and platelet-large cell ratio（P-LCR） of 180 patients with acute cerebral infarction and 180 normal controls were measured by blood cell analyzer, and prothrombin time （PT）, activated partial thromboplastin time （APTT） ,fibrinogen（Fg） and thrombin time（TT） were measured by coagulation analyzer. Dynamic transformation of these markers at the baseline and the time points of the 1 st,2nd ,4th and 48th hour after throm- bolysis treatment were monitored serially. Result Before thrombolysis treatment, the levels of MPV, PLCR and Fg of patients were significantly higher than those in age- and sex-matched normal controls（P 〈 0.05 ） , while the levels of PLT, PT and APTT were significantly lower（ P 〈 0.05 ）. After thrombolysis treatment, the levels of MPV, P-LCR and Fg decreased significantly（ P 〈 0.05 ）, and the levels of PLT, PT and APTT rose quickly（ P 〈 0.05 ）. Conclusion Dynamically monitoring of platelet parameters （ PLT, MPV and P-LCR）and coagulation markers （PT, APTT and TT）can indicate coagulative function of patients with acute cerebral infarction during thrombolysis treatment. Monitoring of these markers can be helpful in thrombolysis treatment.