脑出血急性期凝血机制变化规律研究  

The study of change of coagulation mechanism during acute period of cerebral hemorrhage

作　　者：李红杰[1] 程永杰[1] 许吉一[1] 庆疆[2] 马临庆 程立春 张朝民[1] 

机构地区：[1]长春市中心医院神经内科,吉林长春130051 [2]吉林省人民医院神经内科,吉林长春130021

出　　处：《中风与神经疾病杂志》2007年第5期593-595,共3页Journal of Apoplexy and Nervous Diseases

基　　金：长春市科技局立项科研课题(97077)

摘　　要：目的研究脑出血患者急性期凝血机制的变化规律,并对其相关机制进行探讨。方法将经头部CT检查证实的脑出血80例患者作为观察组,按不同出血量、出血部位分组;正常对照组35例。所有患者发病后1、3、7、14、21d行凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)5项指标检测;24h内血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)测定。结果脑出血组1、3、7d FIB与D-D均明显高于对照组(P<0.01),14、21d恢复至正常水平;FIB、D-D水平升高与出血量呈正相关,与出血部位无关;两组比较PT、APTT、TT均无统计学意义(P>0.05);脑出血组24h内血小板分布宽度(PDW)、平均血小板体积(MPV)明显高于对照组,两组间比较差异有统计学意义(P<0.01);而脑出血组PLT、PCT与对照组比较,无统计学意义(P>0.05)。结论脑出血急性期血浆FIB、D-D含量增加,血小板MPV、PDW增大,提示脑出血后凝血活性代偿性升高并继发纤溶活性增强,同时血小板体积增大、新生血小板增多,促进止血。Objective To study the change of coagulation mechanism during acute period of cerebral hemorrhage. Methods 80 cerebral hemorrhage patients as observed group were divided into subgroups according to hemorrhage quantity and hemorrhage location. 35 normal persons were as control group. PT,APTT,TT,FIB and D-D were determined among all the patients after 1,3,7,14,and 21 days. PLT,PCT,MPV and PDW were determined in 24 hours. Results FIB and D-D were increased in cerebral hemorrhage patients on 1,3d and 7d,compared with control group（P〈0. 01） ,and then to normal level on 14d and 21d. The high levels of FIB and D-D were related to hemorrhage quantity,but not related to hemorrhage location. There were no significant statistical difference in PT,APTT and TT between two groups（P〉0. 05）. PDW and MPV were increased in cerebral hemorrhage patients,compared with control group（P〈0. 01）. There was no significant statistical difference in PLT and PCT between two groups（P〉0. 05）. Conclusion FIB,D-D,MPV and PDW were increased in acute period of cerebral hemorrhage,which confired that coagulation activity and fibrinogen dissolution activity were increased and accelerated hemostasia.

关 键 词：脑出血 凝血4项 D-二聚体 血小板 

分 类 号：R743.34[医药卫生—神经病学与精神病学]