脑梗死患者血浆PAP水平与单核细胞组织因子、t-PA和PAI活性的测定及其意义  

Detection

作　　者：魏影非[1,2] 林果为[1,2] 倪赞明[1,2] 王晓明 俞丽云[1,2] 

机构地区：[1]上海医科大学华山医院 [2]河北省人民医院血液科

出　　处：《上海医科大学学报》1999年第2期109-112,共4页Journal of Fudan University(Medical Science)

摘　　要：目的观察脑梗死（ＣＩ）患者血浆纤溶酶－α２－抗纤溶酶复合物（ＰＡＰ）、凝血酶－抗凝血酶Ⅲ复合物（ＴＡＴ）测定和外周血单核细胞（ＰＢＭＣ）组织因子（ＴＦ）及ｔ－ＰＡ：ａ和ＰＡＩ：ａ的变化及其意义。方法分别应用ＥＬＩＳＡ法、凝血酶和反应法发色底物法测定５０例脑梗死患者、２０例健康对照及２０例非血栓疾病病例对照的血浆ＰＡＰ、ＴＡＴ、Ｆｇｎ含量、ＰＢＭＣＰＣＡ、ＰＢＭＣＴＰＡ和ＰＡＩ活性。结果①脑梗死患者血浆ＰＡＰ、ＴＡＴ及Ｆｇｎ水平明显增高，与病例对照组及正常对照组比较均有显著差异；②脑梗死患者ＰＢＭＣＴＦ活性明显高于健康对照组（Ｐ＜０．０１）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣｔ－ＰＡ活性表达明显低于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣＰＡＩ活性明显高于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。结论血浆ＴＡＴ及ＰＡＰ水平检测可较好的评价脑梗死患者凝血及纤溶系统激活状态。脑梗死患者在细胞水平已处于高凝状态。并在细胞水平存在凝血与纤溶系统失衡。To investigate the levels of plasminα 2antiplasmin complexes(PAP),thrombinantithrombin Ⅲ complexes(TAT),the periperal blood monocyte (PBMC) tissue activity,PBMC tPA activity (tPA:a) and PAI activity (PAI:a) in cerebral infarction (CI) patients,and its clinical significance. Methods PAP and TAT ,Fgn,PBMC PCA,PBMC tPA:a and PAI:a were measured with ELISA enzymatic and chromogenic reaction method respectively in 50 patients with CI and 20 patients of nonthrombosis and 20 healthy subjects as two control groups. Results ① Plasma levels of PAP,TAT and Fgn were significantly higher in the patients with CI [(0.91±0.47)mg/L,(18.90±4.19)μg/L,(4.28±1.29)g/L, P <0.05, P <0.01, P <0.01],than those in the nonthrombosis patient control group [(0.64±0.19)mg/L,(4.50±1.51)μg/L,(3.02±0.85)g/L] and the healthy control group [(0.63±0.16)mg/L,(1.50±0.8)μg/L,(3.34±0.69)g/L].② PBMC TF activity in the CI group [(16.96±3.71)TU/10 5PBMC] was higher than that in the healthy control group [(4.46±3.18)TU/10 5 PBMC, P <0.01] and the non thrombosis control group [(4.75±2.90)TU/10 5 PBMC, P <0.001].PBMC TPA: a in the CI group [(15.98±8.78)IU/10 6 PBMC] was significantly lower than that in the healthy control group [(24.55±19.01)IU/10 6 PBMC, P <0.001] and the non thrombosis patient control group [(24.77±9.68)IU/10 6 PBMC, P <0.001].PBMC PAI:a in the CI group [(5.46±3.2)AU/10 6 PBMC] increased significantly and was higher than that in the healthy control group [(3.64±2.49)AU/10 6 PBMC, P <0.05] and the nonthrombosis patient control group [(2.89±1.47)AU/10 6 PBMC, P <0.001]. Conclusions ① Plasma PAP and TAT are two more sensitive markers to assess the coagulationfibrinolysis state in the cerebral infarction;② At monocyte level, hypercoagulable state exists in patients with CI,and balance can not be kept between coagulafibrinlysis and monocyte level.

关 键 词：脑梗塞 PAP TAT T-PA PAI 单核细胞 

分 类 号：R743.33[医药卫生—神经病学与精神病学]