缺血性脑卒中并发下肢深静脉血栓形成的相关因素:同期住院4320例中发病率1.16%  

Related factors of cerebral arterial thrombosis combined with deep vein thrombosis in lower limbs:an incidence rate of 1.16% among 4320 cases

作　　者：房淑欣 欧东仁[1] 芦璐[1] 

机构地区：[1]山东省交通医院山东省血栓病防治工程技术研究中心,山东省济南市250031

出　　处：《中国临床康复》2005年第21期23-25,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:分析缺血性脑卒中并发下肢深静脉血栓形成患者的资料,探讨其发生原因。方法:山东省血栓病防治中心1993-10/2004-12收治缺血性脑卒中患者4320例,其中合并下肢深静脉血栓形成患者50例,分析其发生率,年龄及并发症,发生部位与时间及类型等临床特点及血液指标血友病因子、血小板表面α颗粒膜蛋白、凝血酶原片断1+2、纤溶酶原和纤溶酶原激活物抑制物活性等的变化。另选择同期健康查体者50例为对照组,也检测凝血、抗凝和纤溶系统分子标志物各指标,两组进行对比。结果:所有100例被试者均进入结果分析。①缺血性脑卒中并发下肢深静脉血栓形成发生率:1.16%(50/4320)。②年龄及并发症:50例中65岁以上的占60%;伴发疾病中以高血压、高血脂最常见;发热、尿潴留、应用脱水药物等是主要诱发因素。③发生部位、时间及类型:80%(40/50)发生在瘫痪侧肢体;发生在脑梗死后1周以内的8例,2～4周内发生的30例,4～8周的7例,6个月以内3例,1年以内2例;14例为中央型,36例为周围型。④凝血、抗凝和纤溶功能与正常人比较:与对照组相比,缺血性脑卒中并发下肢深静脉血栓形成患者的血管性血友病因子、血小板表面α颗粒膜蛋白、凝血酶原片断1+2水平、纤溶酶原激活物抑制物活性均明显升高,而抗凝血酶活性、总蛋白S含量、蛋白C活性、纤溶酶原活性均明显降低,差异均有非常显著性意义(P<0.01～0.001)。结论:随年龄增大,血栓形成的发病率逐步增高,高血压、糖尿病及高血脂是血栓形成的危险因素。老年脑血管病患者偏瘫肢体制动,血液呈高凝状态是下肢深静脉血栓形成的主要因素。提示临床工作中应对高龄、长期卧床、存在高凝状态的缺血性脑卒中偏瘫患者,及早给予针对瘫痪肢体的功能训练,应用必要的抗凝药物,防止下肢深静脉血栓形成的发生。AIM:To analyze the data of patients with cerebral arterial thrombosis combined with deep vein thrombosis in lower limbs,and study the causes of occurrence. METHODS:The experiment was conducted in Shandong Center for Prevention and Treatment of Thrombotic Diseases from October 1993 to December 2004 in 4 320 patients with cerebral arterial thrombosis.Among them, 50 patients combined with deep vein thrombosis in lower limbs were selected to analyze the incidence rate,age,complication,clinical manifestations of occurrence site, time and type,and blood markers of hemophilia agents,alpha granule lemma protein of blood platelet surface, serozyme part 1+2,and changes of plasminogen and activator of plasminogen inhibitor activity. The markers of blood coagulant, anticoagulant and fibrinolytic parameters were tested on 50 healthy people as controls for comparison.RESULTS:All 100 cases were involved in the result analysis.①The incidence rate of cerebral arterial thrombosis combined with deep vein thrombosis in lower limb was 1.16%(50/4 320).②Age and complication: Among 50 patients combined with deep vein thrombosis,60%patients were over 65 years old.Hypertension and hyprlipemia was most common in the accompany diseases.Main induction factors were febrile, retention of urine and the application of desiccation drug,etc.③Occurrence site, time and type:80%(40/50)occurred in paralytic limb.Eight cases occurred within one week after cerebral infarction,30 occurred within 2-4 weeks,7 occurred within 48 weeks, 3 occurred within 6 months and 2 occurred within 1 year.Fourteen cases were central type,and thirtysix were peripheral type.④Comparison of blood coagulation,anticoagulation and fibrinolytic funtion with healthy people: Compared with the control group,hemophilia agents,alpha granule lemma protein of blood platelet surface,serozyme part 1+2, and plasminogen and activator of plasminogen inhibitor activity were significantly increased in patients with cerebral arterial thrombosis combined with deep vein thrombosis i

关 键 词：脑血管意外/并发症 静脉血栓形成 凝血酶原 

分 类 号：R743[医药卫生—神经病学与精神病学]