脑出血后脑组织凝血酶的表达与颅内压和预后的关系  

Relationship between thrombin in human brain to intracranial pressure and prognosis after intracerebral hemorrhage

作　　者：杨伟东 马景 

机构地区：[1]牡丹江市第二人民医院神经外科,黑龙江牡丹江157000 [2]天津医科大学附属总医院神经外科,天津300052

出　　处：《中风与神经疾病杂志》2008年第2期219-221,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的研究凝血酶在高血压脑出血患者脑组织的表达及其与颅内压和预后的关系。方法通过免疫组化方法测定凝血酶的表达,在规定的时间通过腰椎穿刺测量颅内压力(intracranialpressure,ICP),根据出院时患者的神经功能作GOS评分,应用spearman秩相关对数据进行统计学分析。结果凝血酶在35例脑出血患者脑组织标本中均有不同程度的表达,阳性率为0.4686±0.2739,ICP(1d、3d、7d)为309.71±89.89mmH2O;317.71±103.95mmH2O;275.00±85.57mmH2O,GOS评分为2.91±1.31;凝血酶阳性率与ICP(1d、3d、7d)呈中度正相关(rS1=0.640,P<0.05;rS2=0.639,P<0.05;rS3=0.529,P<0.05),与GOS评分呈中度负相关(rS4=-0.800,P<0.05)。结论凝血酶是脑出血后脑水肿形成机制中的重要因素,为将来应用凝血酶抑制剂治疗脑水肿提供了临床依据。Objective To investigate the expression of thrombin in human brain after intracerebral hemorrhage （ICH） and its relationship to Intracranial pressure （ICP） and prognosis of patients. Methods The thrombin expression was examined with immunohistoehemieal method in 35 cases of ICH. Their relationship to ICP and prognosis was also comparatively analyzed with spearman rank correlation. Results Positive staining with thromhin was observed in all tissues,the expression of thrombin averaged 0. 4686 ± 0. 2739 showed moderate positive correlation to ICP （ICPId 309.71 ± 89.89 mmH2O rs 1 = 0.640, P 〈 0.05 ; ICP3 d 317.71 ± 103.95mmH2O rs2 = 0.639 P 〈 0.05 ; ICP7d 275.00 ± 85.57 mmH2O rs3 =0.529 P 〈 0.05 ）, and moderate negative correlation to GOS averaged 2.91 ± 1.31 （ rs4 = - 0.800, P 〈 0. 05 ）. Conclusion Thrombin plays an important role in brain edema formation after ICH, and this study provides evidence that brain edema after ICH might be reduced by therapy of thrombin inhibitor.

关 键 词：凝血酶 颅内压 脑出血 

分 类 号：R743.34[医药卫生—神经病学与精神病学]