急性脑梗死发作期间组织因子途径改变的观察  

Observation on tissue factor pathway during the onset of acute cerebral infarction

作　　者：文志斌[1] 熊石龙[1] 何晓凡[1] 何美霞[1] 贺石林[1] 解勤之[2] 蹇在伏[2] 陈方平[2] 肖波[2] 杨期东[2] 

机构地区：[1]中南大学湘雅医学院生理学系止血与血栓研究室,湖南长沙410078 [2]中南大学湘雅医院,湖南长沙410008

出　　处：《中国危重病急救医学》2003年第9期529-531,共3页Chinese Critical Care Medicine

基　　金：国家自然科学基金重点资助项目(39830 180 )

摘　　要：目的 :观察急性脑梗死 (ACI)与组织因子途径变化以及与该途径有关的其他凝血因子的关系。方法 :71例经 CT确诊为 ACI患者和 5 0名正常人被纳入研究范围。血浆中组织因子 (TF)和组织因子途径抑制物(TFPI)活性测定采用发色底物法 ;抗原测定用酶联免疫吸附法 (ELISA) ;血浆中 F 促凝活性 (F ∶C)和F 促凝活性 (F ∶C)测定用一期凝固法 ;凝血酶原 (F )的活性测定采用 Ecarin法 ;纤维蛋白原 (Fbg)的活性测定采用凝血酶法 ;抗凝血酶 (AT )的测定用肝素辅因子法。结果 :与正常对照组比较 ,ACI患者血浆中TF活性显著增加 (P<0 .0 5 ) ,TF抗原含量显著增加 (P<0 .0 5 ) ,TFPI的活性降低 (P<0 .0 5 ) ,TFPI抗原含量明显降低 (P<0 .0 5 ) ;血浆 F ∶ C显著增加 (P<0 .0 1) ,血浆 F ∶ C明显下降 (P<0 .0 5 ) ,F 活性显著增加(P<0 .0 1) ,Fbg的活性显著增加 (P<0 .0 1) ;AT 活性显著降低 (P<0 .0 1)。结论 :ACI的发生与组织因子途径的启动有关 ,在Objective: To establish the possible relationship between some coagulation factors and the onset of acute cerebral infarction (ACI). Methods: The study population consisted of 71 patient s with ACI confirmed by CT and 50 agematched healthy volunteers. Blood samples were obtained during the onset period of ACI. Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) activity in plasma were assayed with the chromo genic as say. Plasma TF and TFPI antigen were measured with enzyme linked immunoadsorbent assay(ELISA). Plasma FⅦ coagulation activity (FⅦ∶C) and FⅧ coagulation activity (FⅧ∶C) were developed in the onestage system. Plasma prothrombin (FⅡ) was determined with Ecari n assay. Plasma fibrinogen (Fbg) was measured with thrombin assay. Plasma antith rombin Ⅲ activity (ATⅢ) was determined using heparin cofactor acti vity assay. Results: Compared with the control, plasma TF activity and antigen in patients with ACI were significantly higher (both P<0 05). But plasma TFPI activity and antigen were remarkably lo wer in the ACI group (both P<0 05) Pl asma FⅦ∶C was significantly higher (P<0 01), and FⅧ∶C was markedly lower (P<0 05). Plasma FⅡ was remarkably higher (P<0 01). Similarl y the Fbg was significantly higher in the ACI than that in the control group (P<0 01), whereas ATⅢ was significantly lower (P<0 01). Conclusion: The initiation of TF pathway is contributed to the onset of ACI and the blood is in hypercoagulable state during the early period of ACI.

关 键 词：脑梗死 急性 组织因子 组织因子途径抑制物 凝血酶原 因子Ⅶ促凝活性 因子Ⅷ促凝活性 纤维蛋白原 抗凝血酶Ⅲ 

分 类 号：R743.33[医药卫生—神经病学与精神病学]