缺血性脑卒中与血浆纤维蛋白原及活化血小板的相关性研究  

A Study on the Relation of Plasma Fibrinogen and Activated Platelets in Patients with Ischemic Stroke

作　　者：施咏梅[1] 刘韶华[1] 周红[1] 卢航青[1] 

机构地区：[1]东南大学附属中大医院神经内科,江苏省南京市210009

出　　处：《中国卒中杂志》2006年第2期95-97,共3页Chinese Journal of Stroke

摘　　要：目的探讨缺血性脑卒中与血浆纤维蛋白原及活化血小板之间的关系。方法检测168例缺血性脑卒中患者(急性期和恢复期)及40名正常对照者血浆中纤维蛋白原浓度及活化血小板的分子标志物P-选择素(CD_(62)P)、溶酶体蛋白(CD_(63))的表达,并与神经功能缺损程度进行相关分析。结果(1)缺血性脑卒中患者急性期与恢复期纤维蛋白原浓度及CD_(62)P、CD_(63)表达显著高于对照组(P＜0．01);(2)缺血性脑卒中组急性期患者按牛津郡社区卒中计划(OCSP)分为4个亚型,纤维蛋白原浓度及CD_(62)P、CD_(63)表达在完全前循环梗死(TACI)组明显高于部分前循环梗死(PACI)组、后循环梗死(POCI)组及腔隙性梗死(LACl)组(P均＜0．01),PACI组及POCI组明显高于LACI组(P均＜0．01),而PACI组与POCI组间差别无显著性意义(P＞0．05);(3)纤维蛋白原浓度及CD_(62) P、CD_(63)表达与神经功能缺损程度评分呈显著正相关(r分别为0．781、0．843、0．817,P均＜0．01)。结论缺血性脑卒中患者急性期纤维蛋白原浓度及CD_(62) P、CD_(63)表达显著升高,纤维蛋白原、CD_(62) P、CD_(63)可能参与了缺血性脑损伤的病理过程,并间接反映病情程度;恢复期纤维蛋白原浓度及CD_(62) P、CD_(63)表达仍高于对照组,提示恢复期患者仍需积极治疗。Objective To investigate the changes of plasma fibrinogen and activated platelets in patients with ischemic stroke.Methods Totally,168 cases of acute ischemic stroke (both acute and convalescence) and 40 normal controls were test- ed for their content of plasma fibrinogen,CD_(62)P,CD_(63) expression and their correlation with neurological functional deficit scale. Results (1) The content of plasma fibrinogen and expression of CD_(62) P,CD_(63) in acute phase in ischemic stroke was markedly higher than that in controls (P＜0.01).The content of plasma fibrinogen and expression of CD_(62)P,CD_(63) in convalescence is still higher than that of the controls (P＜0.01 ).(2) The acute phase of ischemic stroke were divided into four subtypes ac- cording to the Oxfordshire Community Stroke Project (OCSP).The content of plasma fibrinogen and expression of CD_(62)P,CD_(63) were higher in total anterior circulation infarcts (TACI) group than that of partial anterior circulation infarcts (PACI) group (P＜0.01),posterior circulation infarcts (POCI) group (P＜0.01 ) and lacunar circulation infarcts (LACI) group (P＜0.01),POCI group were clearly higher than LACI group (P＜0.01),but there were no significant difference between PACI and POCI group(P＞0.05).(3) The content of plasma fibrinogen and expression of CD_(62) P,CD_(63) were positively related with neurological functional deficit scale.(r=0.781,r=0.843,r=0.817 respectively,P＜0.01).Conclusion The content of plasma fibrinogen and expression of CD_(62) P,CD_(63) were markedly raised in the acute phase in ischemic stroke,which shows that they might participate in the pathologic process of ischemic cerebral injury and reflects the degree of disease indirectly.The con- tent of plasma fibrinogen and expression of CD_(62) P,CD_(63) in convalescence higher than controls indicates positive treatment for pa- tients.

关 键 词：脑血管意外 纤维蛋白原 P选择素 溶酶体 流式细胞术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]