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目的 研究脑梗死患者血浆组织型纤溶酶原激活物 (t- PA )及其抑制物 (PAI- 1)水平的改变和预后的关系。方法 对 112例脑梗死患者进行了血浆 t- PA、PAI- 1、血糖、血脂的检测及神经功能缺损程度的评分。分为脑梗死组、再梗死组和正常对照组进行比较 ;并根据神经功能缺损程度的评分分为轻型、中型、重型 3组 ,比较各组间的血浆 t- PA、PAI- 1水平差异及其和预后的关系。结果 脑梗死组、再梗死组的血浆 t-PA、PAI- 1水平与正常对照组相比有显著差异 (P <0 .0 1) ;血浆 t- PA水平与神经功能恢复程度呈明显正相关 ,PAI- 1水平则和它呈明显负相关 ;恢复期再梗死患者血浆 PAI- 1水平高于正常对照组。结论 脑梗死患者病初纤溶活性越低 ,预后越差。再梗死患者恢复期血浆 PAI- 1处于持续高水平状态是脑梗死再发原因之一。
Objective To investigate the relationship between the changes of plasma t-PA and its inhibitor (PAI-1) and prognosis in patients with cerebral infarction. Methods The plasma levels of t-PA, PAI-1, blood glucose, blood lipids and neurological impairment were evaluated in 112 patients with cerebral infarction. Divided into cerebral infarction group, re-infarction group and normal control group were compared; and according to the degree of neurological deficit score was divided into three groups: light, medium and heavy, comparing plasma t-PA and PAI- Its relationship with prognosis. Results The levels of plasma t-PA and PAI-1 in cerebral infarction group and re-infarction group were significantly different from those in normal control group (P <0.01). The level of plasma t-PA was positively correlated with the recovery of neurological function , PAI-1 level was negatively correlated with it; PAI-1 level in patients with recurrent infarction was higher than that in the control group. Conclusions The lower initial fibrinolytic activity in patients with cerebral infarction is, the worse the prognosis is. Resuscitation PAI-1 in patients with recurrent infarction at a sustained high level of status is one of the causes of recurrent cerebral infarction.