急性脑梗死患者相关生化指标检测的临床意义

目的：探讨急性脑梗死（ACI）患者治疗前后Hcy、ET-1、hs-CRP、TXA2水平和凝血纤溶指标的变化及临床意义。方法：分别采用ELISA法、发色底物法、凝血酶法、放射免疫法和免疫透射比浊法对68例ACI患者治疗前后Hcy、ET-1、hs-CRP、TXA2和各凝血纤溶指标水平进行检测,并以30例正常健康人作为对照组。结果：①ACI患者治疗前血浆Hcy、ET-1和血清hs-CRP、TXA2含量高于对照组（P〈0.01）,经过治疗,含量均明显下降,其中血浆Hcy、ET-1恢复至正常水平,与对照组间比较差异无统计学意义（P〉0.05）②轻、中、重型组间血浆ET-1和血清hs-CRP、TXA2含量逐渐增加,组间差异有显著性（P〈0.01或0.05）,而中重型患者血浆Hcy含量明显高于轻型患者（P〈0.01）。③经过治疗,ACI患者血浆vWF、GMP-140、Fg和F1＋2含量较治疗前显著下降,而血浆PS活性、PC活性与AT水平较治疗前明显上升（P〈0.01）,其中血浆PS和PC活性与对照组间比较差异无统计学意义（P〉0.05）。④ACI患者血浆中tPA水平低于对照组,血浆PAI-1含量高于对照组（P〈0.01）。治疗后血浆tPA增加,与对照组间差异无统计学意义（P〉0.05）,PAI-1减少,但仍显著高于对照组（P〈0.05）。结论：检测急性脑梗死（ACI）患者Hcy、ET-1、hs-CRP、TXA2和凝血纤溶指标水平的变化对于指导用药、病情观察和预后评估均有重要的临床意义。

Clinical significance of changes in biochemical indexes in patients with acute cerebral infarction

Objective：To study the significance of Hcy,ET-1,hs-CRP,TXA2,parameters of coagulation and fibrinolysis in patients with acute cerebral infarction（ACI） before and after treatment.Methods：ELISA,chromogenic substrate assay,Clauss assay,radioimmune and immune turbidimetric method were used to determine levels of Hcy,ET-1,hs-CRP,TXA2,parameters of coagulation and fibrinolysis in 68 case with ACI before and after treatment,as well as in 30 control normal cases.Results：① Before treatment,the levels of plasma Hcy,ET-1 and serum hs-CRP,TXA2 significantly increased in patients with ACI,higher than those in control group（P0.01）,which decreased after treatment,especially plasma Hcy and ET-1（P〉0.05）.② The levels of plasma ET-1 and serum hs-CRP,TXA2 gradually increased from minor to severe grade（P〈0.01 or 0.05）,while the level of plasma Hcy in modest and severe grade was significantly higher than minor grade（P〈0.01）.③ After treatment,the levels of plasma vWF、GMP-140,Fg and F1＋2 were significantly lower than those before treatment,but plasma PS,PC and AT higher than before treatment（P0.01）,and there was no difference in levels of PS,PA between ACI patients and control group（P〉0.05）.④ The concentration of plasma tPA was significantly lower than control group,while plasma PAI-1 higher than control before treatment（P0.01 or 0.05）.After treatment,tPA increased and PAI-1 decreased,but the level of PAI-1 remained significantly different from control（P〈0.05）.Conclusion：Levels of Hcy,ET-1,hs-CRP,TXA2,parame-ters of coagulation and fibrinolysis could guide drug therapy,evaluate disease severity and its prognosis in patients with ACI.