血浆中PAI-1和TAFI水平与溶栓后出血性转化相关性研究  

Correlation study of plasminogen activator inhibitor-1(PAI-1),thrombin activatable fibrinolysis inhibitor(TAFI) and symptomatic hemorrhagic transformation in stroke patients treated with tissue plasminogen activator

作　　者：孙威[1] 杨颖[1] 李雪媛[1] 王洪志[1] 贾玉杰[2] 马舒贝[3] 张静波[1] 

机构地区：[1]大连市第三人民医院神经内科,辽宁大连116033 [2]大连医科大学病理生理学教研室,辽宁大连116027 [3]大连市中心医院神经内科,辽宁大连116033

出　　处：《中风与神经疾病杂志》2012年第8期722-725,共4页Journal of Apoplexy and Nervous Diseases

基　　金：国家十一五科技支撑计划<缺血性卒中急性期病因诊断;临床分型及规范治疗>(项目编号:2006BA101A11)

摘　　要：目的探索PAI及TAFI对急性脑梗死静脉溶栓后出血性转化的预警作用。方法前瞻性的将溶栓患者分为出血转化组和无出血转化组,对两组患者溶栓前及溶栓后静脉血浆PAI及TAFI浓度进行对比及统计学分析。结果溶栓前两组基线PAI-1水平差异有明显统计学意义(P=0.037)。溶栓后次日复查晨血PAI-1水平出血转化组明显较无出血转化组值更低(P=0.035)。溶栓前出血转化组的基线TAFI水平较无出血转化组比较TAFI值更低(P=0.024)。溶栓后次日复查晨血出血转化组TAFI值同样低于无出血转化组(P=0.042)。结论血浆中PAI-1和TAFI水平与溶栓后出血性转化相关性较高。当溶栓前及溶栓后PAI-1及TAFI的低水平表达均可增加溶栓后出血性转化的风险。Objective To assess the interactions among hemorrhagic transformation in stroke patients treated with tissue plasminogen activator,the plasminogen activator inhibitor-1（PAI-1）,and the thrombin activatable fibrinolysis inhibitor（TAFI）.Methods Serum PAI and TAFI were assayed in blood samples just before and after tPA administration.Samples were divided into two groups as hemorrhagic transformation groups and non-hemorrhagic transformation groups.Results Patients who experienced hemorrhagic transformation showed lower baseline PAI-1（P=0.037）and baseline TAFI（P=0.024）.Similarly,the blood assayed after stroke tPA therapy showed that levels of serum PAI-1 and TAFI were lower in hemorrhagic transformation groups than non-hemorrhagic transformation groups（P=0.035,0.042）.Conclusion Baseline PAI-1 and TAFI levels predict HT after stroke tPA therapy.In the future,these biomarkers could be used to improve thrombolysis safety.

关 键 词：脑梗死 溶栓 纤溶酶原激活物抑制因子 凝血酶激活的纤溶抑制物 

分 类 号：R743[医药卫生—神经病学与精神病学]