CAJ | 학술논문

目的研究不同类型脑梗死后凝血及纤溶系统不同的连续改变.方法发病48 h内的脑梗死患者136例,分为心源性栓塞性脑梗死(CEI)组(45例)、动脉粥样硬化血栓形成性脑梗死(ATI)组(39例)及腔隙性脑梗死(LI)组(52例),以同期年龄、性别匹配的非脑血管病患者为对照组(38例).测定脑梗死患者发病后48 h内、1周及3周时血浆中凝血酶-抗凝血酶Ⅲ复合物(TAT)、纤维蛋白肽A(FpA)和D-二聚体水平.结果 CEI组患者发病后48 h内、1周及3周时血浆中TAT、FpA和D-二聚体水平均显著高于对照组(P值分别<0.01、0.05).ATI组患者发病后48 h内及1周时血浆中TAT和FpA水平显著高于对照组(P值分别<0.01、0.05),发病后1周及3周时血浆中D-二聚体水平显著高于对照组(P值分别<0.01、0.05).LI组患者不同时间各指标与对照组的差异均无统计学意义(P值均>0.05).结论不同类型脑梗死后凝血及纤溶系统的改变是不同的,从而为明确脑梗死的发病机制提供一些线索.
목적 연구불동류형뇌경사후응혈급섬용계통불동적련속개변.방법 발병48 h내적뇌경사환자136례,분위심원성전새성뇌경사(CEI)조(45례)、동맥죽양경화혈전형성성뇌경사(ATI)조(39례)급강극성뇌경사(LI)조(52례),이동기년령、성별필배적비뇌혈관병환자위대조조(38례).측정뇌경사환자발병후48 h내、1주급3주시혈장중응혈매-항응혈매Ⅲ복합물(TAT)、섬유단백태A(FpA)화D-이취체수평.결과 CEI조환자발병후48 h내、1주급3주시혈장중TAT、FpA화D-이취체수평균현저고우대조조(P치분별<0.01、0.05).ATI조환자발병후48 h내급1주시혈장중TAT화FpA수평현저고우대조조(P치분별<0.01、0.05),발병후1주급3주시혈장중D-이취체수평현저고우대조조(P치분별<0.01、0.05).LI조환자불동시간각지표여대조조적차이균무통계학의의(P치균>0.05).결론 불동류형뇌경사후응혈급섬용계통적개변시불동적,종이위명학뇌경사적발병궤제제공일사선색.
Objective To study the changes of coagulation and fibrinolytic functions after different types of cerebral infarctions. Methods A total of 136 patients within 48 h of acute ischemic stroke were included in the present study, and they were divided into three subgroups, including 45 with acute cardioembolic infarction (CEI), 39 with atherothrombotic infarction (ATI), and 52 with lacunar infarction (LI). Thirty-eight age- and sex-matched non-cerebral vascular patients, who were treated in our hospital during the same period, were taken as controls. The plasma levels of thrombin-antithrombin Ⅲ complex (TAT), fibrinopeptide A (FpA) and D-dimer were measured within 48 h, at 1 week, and 3 weeks after the stroke onset. Results The levels of plasma TAT, FpA and D-dimer in the CEI group were significantly higher than those in the control group (P<0.05, 0.01). The levels of plasma TAT and FpA within 48 h and at 1 week in ATI group were significantly higher than those in the control group (P<0.05, 0.01); the level of D-dimer was significantly higher than that in the control group at 1 week and 3 weeks after stroke onset (P<0.05, 0.01). There were no significant differences in the above parameters between the LI group and the control group at all defined time points (P>O. 05). Conclusion Our findings suggest that the changes of coagulation and fibrinolysis are different in patients with different subtypes of cerebral infarctions, which may cast new lights on the mechanism of cerebral infarction.