血纤溶活性变化对缺血性脑梗死复发的影响  

Study on tissue plasminogen activator change in recurrence of stroke patients

作　　者：林望[1] 唐斌[1] 赵红东[1] 

机构地区：[1]南京医科大学附属南京第一医院神经内科,江苏南京210006

出　　处：《东南大学学报（医学版）》2009年第4期266-268,共3页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:研究初次无复发脑梗死患者与再梗死患者急性期、亚急性期和恢复期组织型纤溶酶原激活物(tPA)和纤溶酶原激活物抑制物-1(PAI-1)的变化规律。方法:215例脑梗死患者,按有无脑梗死复发分为脑梗死组(186例)和再梗死组(29例),于发病96 h内,病后14 d、3个月、6个月、9个月、12个月分别采血,测定t-PA和PAI-1的含量。结果:初次无复发脑梗死组与再梗死组在初次发作的急性期,血浆t-PA的水平与PAI-1的水平相似,组间无明显差异。初次无复发脑梗死组与再梗死组血浆t-PA的水平在4 d、3个月、6个月、9个月、12个月均呈下降趋势,组间无明显差异。但PAI-1的水平在初次无复发脑梗死组表现为恢复期比急性期明显降低,再梗死组在急性期和恢复期无明显变化,两组PAI-1的水平在3个月、6个月、9个月、12个月有明显差异。结论:PAI-1的持续升高与脑梗死复发密切相关,在脑梗死复发中发挥了重要作用。Objective To explore the possible variation of tissue plasminogen activator（tPA） and plasminogen ac- tivator inhibitor-1 （PAI-1） concentration over time between first time stroke onset and recurrence group in the acute,con valescent and recovery phases. Method According to the history of the stroke,215 first time stroke occurrence patients were divided into two groups. Plasma concentrations of tPA and PAI-1 were determined in these patients and were reexam- ined after 14 days,3,6,9,12 months respectively. Result In the acute phase,both t-PA and PAI-1 levels were similar in the two groups. The level of t-PA tended to decrease in both groups along with time. However, the level of PAI-1 was decreased only in the first time stroke occurrence group, it did not obviously change in the recurrence group. Conclusion The continually high PAI-1 is closely related with the recurrence of stroke, the fibrinolytic system plays an important role in the recurrence of stroke.

关 键 词：脑梗死 复发 纤溶系统 组织型纤溶酶原激活物 

分 类 号：R743.3[医药卫生—神经病学与精神病学]