抗凝血酶-Ⅲ对短暂性脑缺血发作卒中复发风险的预测作用  

Predictive role of antithrombin Ⅲ effect on the risk of early stroke recurrence in patients with transient ischemic attack

作　　者：王光胜[1] 顾汉沛[1] 常春红[1] 杨同慧[1] 胡媛媛[1] 田媛媛[1] 杨金建[1] 黄利[1] 

机构地区：[1]江苏省沭阳县人民医院神经内科,江苏沭阳223600

出　　处：《中风与神经疾病杂志》2016年第11期1009-1012,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的通过检测短暂性脑缺血发作(TIA)患者的血浆抗凝血酶-Ⅲ(AT-Ⅲ)水平的变化,探讨AT-Ⅲ对TIA后卒中复发风险的的预测作用。方法选择TIA住院患者127例,观察1 w内卒中复发情况,结合MRI检查,分为良好转归101例、影像阳性组16例和临床梗死组10例。所有患者入院24 h内抽取静脉血3 ml进行凝血功能检测,比较3组患者AT-Ⅲ、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB-C)纤维蛋白原降解物(FDP)水平的差异。结果血浆FDP、FIB-C、APTT、PT水平,3组患者比较无统计学差异;3组患者血浆AT-Ⅲ水平比较有显著统计学差异(F=3.158,P=0.040)。其中,临床梗死组患者AT-Ⅲ平均水平显著低于良好转归组(91.27±13.88 vs 102.32±15.94,P=0.037);临床梗死组患者AT-Ⅲ平均水平稍低于影像阳性组,但差异无统计学意义(91.27±13.88 vs 95.79±13.08,P=0.417)。结论 AT-Ⅲ对短暂性脑缺血发作早期卒中复发风险有预测作用。Objective To explore the predictive effect of antithrombin Ⅲon the risk of transient ischemic attack re-currence .Methods Patients with TIA （ n=127 ） were divided into good prognosis group （ n=101 ） and adverse prognosis group（ n=26） according to recurrent stroke within 1 weeks and checking of MRI .Cases of adverse prognosis patients in-cluded 16 cases of positive image and 10 cases of clinical cerebral infarction .PT、APTT and FIB-C activity were detected by coagulation method ,FDP was detected by the method of immune turbidity ,and AT-Ⅲwas determined by the method of chromogenic substrate in all patients within 24 hours.Levels of serum AT-Ⅲ、PT、APTT、FIB-C and FDP were compared in three groups .Results There was no significant difference in the levels of FDP、FIB-C、APTT and PT between three groups.Significant difference of AT-Ⅲlevel was identified among three groups （F=3.158,P=0.040）.The level of AT-Ⅲin the clinical cerebral infarction group was significantly lower than that in the good prognosis group （91.27 ±13.88 vs 102.32 ±15.94,P=0.037）.Conclusion AT-Ⅲhas a predictive effect on the risk of early stroke recurrence in patients with transient ischemic attack .

关 键 词：脑缺血 短暂性 抗凝血酶-Ⅲ 卒中 复发 

分 类 号：R743[医药卫生—神经病学与精神病学]