急性脑血管病及并发神经源性肺水肿的临床分析  

Clinical study on acute cerebral vascular disease with neurogenic pulmonary edema

作　　者：朱艳玲[1] 刘琦[2] 赵明祥[2] 吴珊[2] 

机构地区：[1]河南省鹤壁煤业(集团)有限责任公司总医院神经内科,鹤壁458000 [2]贵阳医学院附属医院神经内科

出　　处：《陕西医学杂志》2009年第4期446-448,共3页Shaanxi Medical Journal

基　　金：贵州省"十五"攻关项目[黔科和农社字(2001)1141号]

摘　　要：目的:通过研究组织因子(TF)及组织因子途径抑制物(TFPI)在急性脑血管病及并发神经源性肺水肿(NPE)中的变化及临床意义,探讨NPE发生的可能机制。方法:选择脑血管病急性期患者63例和健康体检者26例;采用双夹心酶联免疫吸附抗原测定(ELISA)法测定患者血浆中TF和TFPI的含量,与正常对照组及组间进行比较。结果:1出血量及梗死面积较大者,易并发NPE;并发NPE的患者血浆中TF、TFPI均高于无NPE的患者(P<0.05);2脑血管病急性期TF均高于对照组(P<0.01);而TFPI在脑出血组高于对照组(P<0.05),在脑梗死组却低于对照组(P<0.05)。结论:1脑血管病急性期血液存在高凝状态,炎症反应与凝血异常可能共同导致肺损伤;2血浆TFPI与脑血管病的类型及严重程度有关。Objective ： To explore the relationship of tissue factor and tissue factor pathway inhibitor in acute cerebral vascular diseases with neurogenic pulmonary edema. Methods ： 63 patients with ACVD and 26 age matched healthy volunteers were enroued. Plasmatic levels of TF and TFPI were examined with ELISA technique. Results ：①Patients with bigger hemorrhagic volume or infarction sizes were easily combined with NPE; Patients with NPE had higher TF,TFPI contents in plasma than those who had not NPE complication （P 〈0.05） ;②The TF levels in acute cerebral vascular diseases were higher than the control group（P〈0. 01）,but TFPI levels in the acute stage of cerebral hemorrhage were all higher than the control group（P〈0.05）, the levels in cerebral infarction were lower than the control group（P〈0. 05） . Conclusions： ①hypereoagulab state existes in the acute stage of cerebral hemorrhage and infarction, the inflammatory responds and the coagulation abnormality may be related to lung injury;② The content of TFPI in plasma is related to the catalogue and degree of cerebral vascular disease.

关 键 词：脑梗塞/并发症 脑出血/并发症 肺水肿/病理学 凝血致活酶/血液 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R651.15[医药卫生—临床医学]