脑梗塞患者血脂蛋白(a)、纤溶系统活性状态及其相关性研究  

Serum Lipoprotein(a) Levels, Plasma Fibrinolytic Conditions and Their Correlations in Patients with Acute Cerebral Infarction

作　　者：张颖冬[1] 刘锡民[1] 蔡转[1] 杨明山[1] 

机构地区：[1]同济医科大学附属同济医院神经内科,武汉430030

出　　处：《同济医科大学学报》1997年第3期191-194,共4页Acta Universitatis Medicinae Tongji

摘　　要：对30例皮质动脉区脑梗塞（CACI）、32例穿通动脉区脑梗塞（PACI）患者及30名年龄性别与CACI患者匹配的对照者测定血脂蛋白（a）［Lp（a）］及纤溶系统活性指标。结果：CACI患者Lp（a）水平显著高于对照者［分别为（411．21±230．42）、（204．09±171．45）mg／L，P＜0．01］，而PACI患者LP（a）水平为（301．15±198．84）mg／L，介于两者间；且两类型脑梗塞患者纤溶系统活性均显著低于对照者（均为P＜0．01）。相关分析结果表明Lp（a）可能通过对组织型纤溶酶原激活物负性影响及（或）纤溶酶原激活物抑制物正性影响而干扰纤溶系统活性。高水平Lp（a）是动脉粥样硬化性脑梗塞的危险因素。In this paper, we studied the serum Lp(a) levels and plasma fibrinolytic variables, including plasma tPA activity, PAI activity, endothelial capacity of tPA release and PAI/tPA ratio, of 30 patients with cortical artery territory cerebral infarction (CACI) and 32 patients with perforating artery territory cerebral infarction (PACI), and of 30 control subjects whose age and sex were matched with those of CACI cases.The results showed that the mean serum Lp (a) level of CACI patients was remarkedly higher than that of controls [(411. 21±230.42) mg/L, (204. 09±171.45) mg/L, respectively, P<0.01], and the mean serum Lp (a) level of PACI patients [(301. 15±198. 84) mg/L], however, was between those of controls and CACI patietns. And the plasma fibrinolysis determined by the comprehensive panel of assay of both subtypes of stroke patients was significantly lower than that of controls (both P<0.01). Analysis by correlation coefficients and other tests suggest that Lp (a) may interfere with the plasma fibrinolytic activlty by influencing tPA activity negatively and/or PAI activlty positively. It is further proved that high serum Lp (a) level is a risk factor for atherosclerotic cerebral infarction.

关 键 词：脑栓塞 脂蛋白类 纤溶酶原激活物 抑制物 

分 类 号：R743.330.2[医药卫生—神经病学与精神病学]