原发性高血压伴急性脑血管病凝血纤溶异常的研究  

Abnormality of Coagulation and Fibrinolysis in Essential Hypertensive Patients with Acute Stroke

作　　者：吴春波[1] 朱继红[1] 孙宁玲[1] 

机构地区：[1]北京医科大学人民医院,北京100044

出　　处：《高血压杂志》2000年第3期217-218,共2页Chinese Journal of Hypertension

摘　　要：目的 :观察原发性高血压及伴发急性脑卒中患者的部分凝血纤溶指标变化 ,为临床诊治提供依据。方法 :将研究对象分为四组 ,原发性高血压 A组 (n=45例 ) ;急性脑出血 B组 (n=45例 ) ;急性脑梗塞 C组 (n=5 2例 )和对照组 D组 (n=38例 )。并分析发作期患者的血压及部分凝血纤溶指标的变化。结果 :各组患者血浆纤维蛋白元 (FIB)水平均较正常人明显升高 ,急性脑卒中患者尤甚 ,脑出血与脑梗塞间无差异。并出现组织型纤溶酶原激活物 (t PA)和组织型纤溶酶原激活物的抑制物 (PAI- 1 )含量增高 ,活化蛋白 C(APC)敏感度下降现象。结论 :原发性高血压患者存在高 FIB血症及纤溶功能抑制 ,可能是其并发急性脑血管病的原因之一。Objective:To observe the changes of coagulation fibrinolysis in essential hypertensive patients with or without acute stroke in attempt to provide rational clinical diagnosis and treatment. Method:Patients were divided into four groups: Group a:essential hypertension( n =45); Group b:acute cerebral hemorrhage( n = 45); Group C:acute cerebral infarction ( n =52); and Group D:healthy subjects as control. Coagulative and fibrinolytic parametersin and blood pressure were analysed. Results:The plasma levels of fibrinogen(FIB) in the former three groups are apparently higher than the control group. Group b and c being highest.No differences of FIB were found between acute cerebral hemorrhage and acute cerebral infarction. The tissue plasminogen activator (t PA) and plasminogen inhibitor (PAI 1) were increased, and active protein C sensitivity fell in group b and group c. Conclusion:The patients with essential hypertension had a decreased fibrinolytic function and hyperfibrinogenemia which may be one of the risk factor of essential hypertension complicated with acute stroke. Correlation between the active protein C resistant phenomenon and acute stroke was demonstrated.

关 键 词：原发性高血压 急性脑血管病 凝血 纤溶 

分 类 号：R544.1[医药卫生—心血管疾病] R743.34[医药卫生—内科学]