脑出血后凝血与纤溶系统紊乱及其对预后的影响  

DISTURBANCES OF BLOOD COAGULATION AND FIBRINOLYSIN AFTER CEREBRAL HEMORRHAGE AND THEIR EFFECT ON PROGNOSIS

作　　者：吴向东[1] 黄伟[1] 吴向军[2] 解伟华[2] 

机构地区：[1]大连医科大学附属第一医院中心ICU,116011 [2]大连市儿童医院检验科,116011

出　　处：《中国现代医学杂志》2003年第4期43-44,47,共3页China Journal of Modern Medicine

摘　　要：目的 :研究脑出血早期凝血与纤溶系统功能障碍 ,并探讨其与脑出血程度及预后的关系。方法 :4 7例脑出血患者和 32例急性单纯性阑尾炎患者于入院 6h内行DIC筛选试验与部分凝血活酶时间 (APTT)测定 ,并分别根据Glasgow(GCS)昏迷评分和D -聚体 (D -dimer)测定值对脑出血病人进行分组 ,计算各组的死亡率。结果脑出血组的凝血酶原时间 (PT)、凝血酶时间 (TT)、D -dimer及APTT值明显高于对照组 (P <0 .0 5 ) ;按GCS评分分组 ,GCS评分越低 ,D -dimer值越高 (P <0 .0 5 ) ;按D -dimer值分组 ,D -dimer值越高 ,死亡率越高 (P <0 .0 5 )。结论 :脑出血早期存在凝血与纤溶系统紊乱 ,D -dimer是准确判断脑出血早期病情严重程度及预后的可靠指标。Objective:To investigate the disturbances of blood coagulation and fibrinolysin in early stage of cerebral hemorrhage, and evaluate their effect on diagnosis. Methods:Forty-seven patients with cerebral hemorrhage (group A) and 32 patients with acute appendicitis (group B) were measured DIC screen tests and APTT during 6 hours at admission.Patients with cerebral hemorrhage also stratified by the results of Glasgow Coma Scales (GCS) or D-dimer,and mortality rate were evaluated respectively. Results:PT, TT, D-dimer and APTT in group A were significantly higher than those in group B ( P <0.05); there was also a significant correlation between GCS and D-dimer. A significant increase in mortality rate was observed among patients with higher D-dimer. Conclusion:Dysfunction of blood coagulation and fibrinolysin systems may be exist during early stage of cerebral hemorrhage; the level of D-dimer should be a reliable marker for evaluating disease severity and prognosis.

关 键 词：脑出血 预后 凝血 纤溶系统紊乱 纤溶系统功能障碍 早期 凝血酶原时间 

分 类 号：R743.34[医药卫生—神经病学与精神病学]