蛛网膜下腔出血患者脑血管痉挛、缺血性神经元损伤和再出血的机理探讨  

Mechanism of vascular spasm,ischemic nerve lesion and rehemorrhage in patients with subarachnoid nemorrhage

作　　者：郭沂涟[1] 许继平[1] 

机构地区：[1]山东大学第二医院,山东济南250033

出　　处：《山东医药》2001年第19期1-2,共2页Shandong Medical Journal

摘　　要：为研究蛛网膜下腔出血 (SAH)患者急性期血液流变学、血凝学及 D-二聚体的动态变化 ,探讨其在SAH后发生脑血管痉挛 (CVS)、迟发性缺血性神经元损伤 (DID)及再出血的意义 ,以指导治疗 ,动态检测了 30例SAH患者的血液流变学、血凝学及 D-二聚体变化 ,并与 5 0例神经外科手术患者比较。结果 SAH患者发病 10天内全血粘度 (高、低切 )、血浆粘度和 D-二聚体持续增高 ,f蛋白原初始增高、1周后降低 ,与对照组比较有显著差异 (P<0 .0 1) ;SAH组凝血时间 (CT)、活化部分凝血活酶时间 (APTT)、血浆凝血酶原时间 (PPT)明显缩短 ,P<0 .0 1。认为 SAH患者急性期处于高粘、高凝、高纤溶状态 ,此为 SAH急性期应用扩容及抗纤溶药物预防 CVS。To study the significance of the change of hemorrneoiogy,hemoagglution and D dimer in patients with subarachmoid hemorrhage(SAH) Several indexes of 30 cases of SAH and 50 patients of neurosurgery were dynamicly detected Results showed that in SAH groups,the whole blood viscosity,plasma viscosity and D dimer maintain increased,fibrinogen increased beginning and then decreased after a week Clotting time(CT),activated partial thromboplastin time(APTT)and plasma prothrombin time(PPT)decreased The result suggests it is helpful to treat with increasing blood capacity and antihyperfibrinolysis drugs for the hyperviscosity,hypercoagulability and hyperfibrinolysis in SAH patients

关 键 词：蛛网膜下腔出血 血液流变学 血凝学 D-二聚体 脑血管痉挛 缺血性神经元损伤 再出血 

分 类 号：R743.35[医药卫生—神经病学与精神病学]