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目的观察急性脑梗死患者早期血浆血栓前体蛋白(TpP)水平动态变化,探讨不同神经功能缺损患者TpP水平变化。方法选取发病24h内入院的40例急性脑梗死患者,在入院时、发病48h、72h、7d、10d抽取静脉血;对照组为40例健康体检者。采用酶联免疫吸附法测定TpP。采用NIHSS评分评价患者神经功能情况,比较两组患者TpP水平变化。结果急性脑梗死患者在发病后24h内TpP开始升高,与对照组相比较差异有统计学意义(P<0.01),48h达到高峰,72h仍维持在较高水平;随着病程的延长,7d明显下降,10d逐渐恢复正常。40例急性脑梗死患者分为轻度神经功能缺损21例,血浆TpP峰值水平为(12.35±1.08)μg/ml;中、重度神经功能缺损19例,血浆TpP峰值水平(19.35±1.56)μg/ml。不同神经功能缺损患者TpP水平比较差异有统计学意义(P<0.05),神经功能损伤越重,TpP水平越高。结论急性脑梗死不同发病时间血浆TpP水平亦不同,TpP可作为诊断、了解发病过程、判断预后、评价治疗效果的指标。
Objective To observe the dynamic changes of early plasma thromboplastin (TpP) levels in patients with acute cerebral infarction and to explore the changes of TpP levels in patients with different neurological deficits. Methods Forty patients with acute cerebral infarction who were admitted to hospital within 24 hours of onset of illness were enrolled in the study. Venous blood was drawn at 48 hours, 72 hours, 7 days and 10 days after admission. The control group consisted of 40 healthy subjects. TpP was determined by enzyme-linked immunosorbent assay. The NIHSS score was used to evaluate the neurological function of patients, and the changes of TpP levels in both groups were compared. Results The level of TpP in patients with acute cerebral infarction began to increase within 24 hours after onset, which was significantly different from that in control group (P <0.01), peaked at 48 hours and maintained at a high level at 72 hours. With the prolongation of duration, Significantly decreased, 10d gradually returned to normal. Forty patients with acute cerebral infarction were divided into mild neurological deficit (21 cases), plasma TpP peak value (12.35 ± 1.08) μg / ml, moderate and severe neurological deficit in 19 cases, peak plasma TpP level (19.35 ± 1.56) μg / ml. There were significant differences in TpP levels between different neurological deficits (P <0.05), more severe neurological impairment, and higher TpP levels. Conclusions The plasma TpP levels in different stages of onset of acute cerebral infarction are also different. TpP can be used as a diagnostic indicator to understand the course of the disease, predict the prognosis and evaluate the therapeutic effect.