摘要
目的 探讨自发性蛛网膜下腔出血 (SAH)患者血中纤溶活性的变化规律及其临床意义。方法 对4 0例 SAH患者及 30例查体健康者 (对照组 )行血组织型纤溶酶原激活物活性 (t PA∶ A)及纤溶酶原抑制物活性(PAI∶A)测定 ,纤溶酶原抑制物 - 1(PAI- 1)及 D-二聚体 (D- D)定量测定。SAH患者分别于发病后 0～ 3天 (急性期 )、4～ 9天 (再出血高峰期 )及 14～ 2 1天 (吸收期 )进行检测。结果 SAH组急性期 t PA∶ A显著低于对照组 ,并随病程延长而显著升高 ,至吸收期达正常水平 ,与对照组比较无显著差异 ;急性期 PAI∶ A及 D- D水平显著高于对照组 ,并随病程延长而显著降低 ,至吸收期降至正常水平 ,与对照组比较无显著差异 ;各期 PAI- 1水平与对照组均无显著差异。结论 SAH后患者血中不存在纤溶活性亢进。再出血高峰期血中纤溶活性变化均显著低于急性期 ,再出血与血中纤溶活性无关。故 SAH后不宜长期大剂量应用抗纤溶药物预防再出血。
Objective To evaluate the natural course of fibrinolytic activity in the blood in patients with spontaneous subarachnoid hemorrhage(SAH) and clinical significance.Methods The activity of tissue-type plasminogen activator (tPA∶A)and plasminogen activator inhibitor(PAI∶A) in the blood from 40 patients with SAH and 30 normal persons were measured by means of synthetic chromogenic subastrate method,the levels of plasminogen activator inhibitor-1(PAI-1) antigen and D-dimer (D-D) were measured by enzyme-linked immunosorbent assay (ELISA).Blood samples in patients with SAH were obtained three times.Results In the blood of SAH,the tPA∶A on days 0 to 3 and 4 to 9 after SAH were significantly lower than in the control group,and increased significantly with time.The changes of PAI∶A and D-D were significantly higher.The levels of PAI-1 showed no significant change as compared with the control group.Conclusion No hyperfibrinolysis exist in the blood after SAH.Fibrinolytic activity may not be involved in the mechanism of rebleeding.These data do not support the use of antifibrinolytic drugs in the treatment of patients with SAH.
出处
《山东医药》
CAS
北大核心
2005年第1期5-7,共3页
Shandong Medical Journal
