脑血管病与高凝状态的关系  

Correlation between hypercoagulation and cerebrovascular disease

作　　者：邱丽君[1] 汪维乐[1] 周琪[1] 沈霞[1] 

机构地区：[1]上海第二医科大学新华医院检验科,上海200092

出　　处：《上海第二医科大学学报》2004年第6期448-450,453,共4页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的探讨脑血管病患者内皮细胞功能、血小板活化、凝血因子活性的变化及意义。方法116例脑血管病患者,其中脑出血组48例、脑梗死组39例、腔隙梗死组29例,应用ELISA法检测血管性血友病因子(vWF)、P-选择素(P-selectin)、内皮素-1(ET-1)、组织因子(TF)、组织因子途径抑制物(TFPI),应用Clauss法检测纤维蛋白原含量(Fg),并比较各指标在脑血管病组与对照纽(n=40)间的差异。结果各项指标,除腔隙性梗死组的ET-1、TFPI外,与对照组比较,脑血管病患者均高于对照组(P<0.05)。脑梗死组与腔隙梗死组比较,除vWF无显著差异外,其余各项指标均有显著性差异(P<0.05)。脑梗死组与脑出血组比较,除TF有显著性差异外(P<0.05),其余各项指标均无显著性差异。结论脑血管病患者存在内皮细胞损伤、血小板活化、凝血因子的激活,脑梗死和腔隙梗死各项指标的异常程度与梗死的面积大小相一致。脑血管病患者均存在有高凝状态,特别是脑出血患者同样存在着高凝状态。Objective To investigate the changes of endothelial function , platelet activation, coagulation factors activity in patients with cerebrovascular disease and their clinical values. Methods von Willebrand factor ( vWF) , endothelin-1 (ET-1) , P-selectin , tissue factor ( TF ) , tissue factor pathway inhibitor (TFPI) were measured with ELISA and fibrinogen was analyzed with Clauss assay in 116 patients with cerebrovascular disease, including 48 with cerebral hemerrhage,39 with cerebral infarct,29 with lacunar infarct,while the same indices were measured in 40 normal control subjects. Results The mean indices in patients with cerebrovascular disease were higher than those in normal controls(P <0. 05) excel ET-1 and TFPI in patients with lacunar infarct (P >0.05). There was significant difference in the plasma indices between patients with cerebral infarct and lacunar infarct (P <0. 05) with excetion of vWF(P >05). Compared with the cerebral hemerrhage group, the plasma level of TF was significantly higher (P <0.05) and the mean values of vWF, ET-1, Fg, P-selectin and TFPI had marked no changes(P > 0. 05) in the group of cerebral infarct. Conclusion There were injury of the vascular endothelium, activation of platelets and increase of coagulation in the patients with cerebrovascular diseases. Abnormality these indices was correlated to the area of infarct between cerebral infarct and lacunar infarct. The results implied that patients with cerebrovascular diseases, including cerebral hemerrhge, had blood hypercoagulation tendency.

关 键 词：脑血管病 高凝状态 凝血因子 脑梗死 

分 类 号：R743[医药卫生—神经病学与精神病学]