急性脑梗塞rt-PA静脉溶栓后凝血、纤溶指标动态变化及临床意义.docVIP

精品论文 参考文献 急性脑梗塞rt-PA静脉溶栓后凝血、纤溶指标动态变化及临床意义 蔡俊秀 刘志英 胡霞 [摘 要]目的：研究探讨急性脑梗死患者rt-PA静脉溶栓治疗后患者凝血、纤溶指标变化情况。方法：选取经rt-PA静脉溶栓治疗的急性脑梗塞患者30例，比较溶栓前后的不同时间点患者的凝血、纤溶指标动态变化情况。结果：静脉溶栓后，患者的TT、APTT、PT均延长，Fib水平下降，但溶栓后6h内的变化差异不大（P＞0.05）；TAT在溶栓后2h、6h明显增高，溶栓后12h迅速下降。D-D在溶栓后2h显著升高，24h后降低，与溶栓前相比，水平仍比较高，比较均有统计学差异（P＜0.05）。FDP则表现出溶栓后2h明显增高，溶栓后24h降至原水平的情况。T-PA溶栓后即刻直线上升，与溶栓前相比有显著差异（P＜0.05）；PAI-1的变化与T-PA大致相反。结论：溶栓治疗后凝血与纤溶并存，而以纤溶占优势，该规律可以为rt-PA静脉溶栓安全性、有效性提供指导。 [关键词]急性脑梗塞 rt-PA静脉溶栓 凝血指标 纤溶指标 动态变化 DOI:10.3760/cma.j.issn.0376-2491.2016.16.11 作者单位：830011，新疆，新疆医科大学第五附属医院 通信作者：胡霞，Email：2660181731@。 支持项目：新疆医科大学第五附属医院基金项目（项目编号WFY2014014） Index of the dynamic changes and clinical significance of coagulation and fibrinolysis in patients with acute cerebral infarction rt-PA after intravenous thrombolysis Cai Junxiu,Liu Zhiying,Hu Xia Abstract：Objective: To study the changes of coagulation and fibrinolysis in patients with acute cerebral infarction after intravenous thrombolytic therapy in patients with rt-PA. Methods: 30 patients with acute cerebral infarction treated by rt-PA were selected, and the dynamic changes of coagulation and fibrinolytic index were compared before and after thrombolysis. Results: PT, TT, APTT were increased and Fib levels was decreased in 6 hours, but the changes were not significant (P gt; 0.05).TAT was sharply increased in 2 hours and 6 hours，then decreased after 12 hours. D-D was significantly increased after 2h thrombolysis, and the level of 24h was significantly higher than before treatment, and the difference was statistically significant(P lt; 0.05). FDP of 2 hours was significantly higher than that of 24 hours after thrombolysis. T-PA was great increased just after embolysis.the changes of PAI-1 was on the contrary.Conclusion: After dissolving embolus，coagulation and fibrinolysis existed simultaneously，but fibrinolysis is in superior.The phenomenon is important for the safety and effect of rt-PA vein thrombolysis. Keywords：acute cerebral inf