微创血肿清除术患者纤溶活性动态变化的研究  

Dynamic fluctuation of fibrinolytic activity in patients with mini-invasive hematoma aspiration

作　　者：田敏[1] 袁倩[1] 崔元孝[1] 张清华[1] 唐茜茜[1] 

机构地区：[1]山东大学附属省立医院神经内科,济南250021

出　　处：《山东大学学报（医学版）》2010年第10期73-76,共4页Journal of Shandong University:Health Sciences

基　　金：山东省自然科学基金资助项目(Y2006C79;Y2008C27)

摘　　要：目的观察高血压性脑出血患者微创血肿清除术后纤溶活性的动态变化。方法采用酶联免疫吸附试验双抗体夹心法,测定高血压性脑出血微创术患者46例(手术组)、非手术患者43例(非手术组)发病后1、3、7、14d血清组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)的含量,将48名同期健康查体者作为正常对照组,对各组的t-PA、PAI-1水平进行比较。结果高血压性脑出血手术组1、3、7d血清t-PA及3、7d血清PAI-1水平显著高于正常对照组(P<0.05),至14d与正常对照组差异无统计学意义;手术组3、7d血清t-PA水平明显低于非手术组(P<0.05),PAI-1水平明显高于非手术组(P<0.05);手术组1、3、7d血清t-PA及PAI-1的含量均与当天美国国立卫生院(NIHSS)评分相关。结论高血压性脑出血患者微创术后血液纤溶活性存在一定变化规律,血清t-PA、PAI-1可作为判断微创术临床疗效的生物学指标。Objective To investigate the dynamic fluctuation of fibrinolytic activity in hypertensive intra-cerebral hemorrhage patients with minimally invasive surgery（MIS）.Methods Blood samples were obtained on days 1,3,7 and 14 after onset from 46 patients with MIS and 43 patients with non-minimally invasive surgery,48 normal subjects were controls.Levels of plasminogen activator inhibitor-1（PAI-1） antigen and tissue-type plasminogen activator（t-PA） were measured with enzyme linked immunosorbent assay（ELISA）.Results Level of t-PA in the MIS group on days 1,3 and 7 after onset was significantly higher than that in the control group（P0.05）,while there was no significant difference between the MIS group and the control group on day 14.Level of PAI-1 in the MIS group on days 3 and 7 was significantly higher than that in the control group（P0.05）.Level of t-PA in the MIS group on days 3 and 7 was significantly lower than that in the non-minimally invasive surgery group（P0.05）,while level of PAI-1 in the MIS group on days 3 and 7 was significantly higher than that in the non-minimally invasive surgery group（P0.05）.Levels of t-PA and PAI-1 in the MIS group on days 1,3 and 7 had a correlation with the National Institutes of Health Stroke Scale（NIHSS）.Conclusion A fluctuation regularity exists in fibrinolytic activity in hypertensive intracerebral hemorrhage patients with MIS.Levels of t-PA and PAI-1 can be used as biomarkers for clinical outcomes in patients with MIS.

关 键 词：颅内出血 高血压性 纤溶酶原激活剂 纤溶酶原灭活剂 微创术 

分 类 号：R743.34[医药卫生—神经病学与精神病学]