摘要
目的探讨脑梗死患者溶栓治疗前后血脂水平和凝血功能参数的变化,为临床治疗脑梗死提供科学依据。方法 (1)对81脑梗死患者根据头部CT或MRI病灶大小,梗死体积按Pullicino公式(长×宽×层数/2)计算进行分组:大梗死组(病灶体积>10cm^3)10例,中梗死组(病灶体积4~10cm^3)22例,小梗死组(病灶体积<4cm^3)49例,设健康对照组50例。(2)分别在溶栓治疗前24小时内、溶栓治疗后24h内、第3天和第7天采集脑梗死组血标本,进行血脂指标:甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AI(APOAI)、载脂蛋白B(APOB)和脂蛋白(a)[Lp(a)];凝血功能指标:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和血浆D二聚体(D-D)检测及统计学分析。结果 (1)大、中、小梗死组溶栓治疗前24h内TG、TC、LDL-C、APOAI、APOB和Lp(a)高于对照组(P<0.01),HDL-C低于对照组(P<0.05);大梗死组溶栓治疗前24h内TG、TC、LDL-C、APOAI、APOB和Lp(a)高于小梗死组(P<0.05)。(2)大梗死组溶栓治疗前24h内TG、TC、HDL-C、LDL-C、APOAI、APOB和Lp(a)与溶栓治疗后24h内、第3天和第7天比较差异无统计学意义(P>0.05)。(3)大、中、小梗死组溶栓治疗前24h内FIB和D-D高于对照组(P<0.01),PT和APTT低于对照组(P<0.05),TT无统计学差异(P>0.05)。(4)大梗死组溶栓治疗前24h内FIB和D-D高于小梗死组(P<0.05),PT、APTT和TT较小梗死组无统计学差异(P>0.05)。(5)大梗死组溶栓治疗后24h内、第3天和第7天D-D、PT和APTT明显高于溶栓治疗前24h内水平(P<0.01)。结论脑梗死患者溶栓治疗前后血脂水平和凝血功能指标有明显变化,其水平变化可作为脑梗死治疗及预后的判断指标。
Objective To explore the variations of cerebral infarction patients＇ blood lipid and blood coagulation functional indexes before and after thrombolytic therapy, and provide scientific references for clinical treatment of this disease. Methods According to infarction volume on head CT or MRI, 81 cerebral infarction patients were divided into three groups, 10 cases in large infarction group（ 10cm^3）, 22 cases in middle infarction group（4- 10cm^3）, 49 cases in small infarction group（ 4cm^3）, and another 50 healthy individuals were selected as control group, the infarction volumes were calculated by Pullicino formula（Length×Width×Layers/2）. The cerebral infarction specimens of patients within 24 hours before thrombolysis, within 24 hours after thrombolysis, at the 3rd and 7th days after thrombolysis were collected. The blood lipid indexes, including triglyceride（TG）, total cholesterol（TC）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C）, apolipoprotein AI（APOAI）, apolipoprotein B（APOB）, lipoprotein（a） [Lp（a）], and the blood coagulation functional indexes, including prothrombin time（PT）, activation activated partial thromboplastin time（APTT）, thrombin time（TT）, fibrinogen（FIB）, plasma D-dimer（D-D） were tested and analyzed. Results In the three infarction groups, within 24 hours before thrombolysis, the TG, TC, LDL-C, APOAI, APOB and Lp（a） were higher than those of the control group（P〈0.01）, the HDL-C was lower than that of the control group（P〈0.05）. In the large infarction group, within 24 hours before thrombolysis, the TG, TC, LDL-C, APOAI, APOB and Lp（a） were higher than those of the small infarction group（P〈0.05）, and were not statistically different with those within 24 hours, at the 3rd and 7th days after thrombolysis in the same group（P〈0.05）. In the three infarction group within 24 hours before thrombolysis, the FIB and D-D werehigher than those of control group（P〈0
出处
《中国医药科学》
2016年第7期29-33,共5页
China Medicine And Pharmacy
关键词
脑梗死
血脂
凝血功能
溶栓
预后
Cerebral infarction
Blood lipid
Blood coagulation function
Thrombolysis
Prognosis
