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目的研究凝血酶在高血压脑出血患者脑组织的表达及其与颅内压和预后的关系。方法通过免疫组化方法测定凝血酶的表达,在规定的时间通过腰椎穿刺测量颅内压力(intracranialpressure,ICP),根据出院时患者的神经功能作GOS评分,应用spearman秩相关对数据进行统计学分析。结果凝血酶在35例脑出血患者脑组织标本中均有不同程度的表达,阳性率为0.4686±0.2739,ICP(1d、3d、7d)为309.71±89.89mmH2O;317.71±103.95mmH2O;275.00±85.57mmH2O,GOS评分为2.91±1.31;凝血酶阳性率与ICP(1d、3d、7d)呈中度正相关(rS1=0.640,P<0.05;rS2=0.639,P<0.05;rS3=0.529,P<0.05),与GOS评分呈中度负相关(rS4=-0.800,P<0.05)。结论凝血酶是脑出血后脑水肿形成机制中的重要因素,为将来应用凝血酶抑制剂治疗脑水肿提供了临床依据。
Objective To study the expression of thrombin in patients with hypertensive intracerebral hemorrhage and its relationship with intracranial pressure and prognosis. Methods The expression of thrombin was measured by immunohistochemical method, intracranial pressure (ICP) was measured by lumbar puncture at the prescribed time, and GOS score was calculated according to the neurological function of patients discharged from the hospital. Spearman rank correlation was used to analyze the data . Results Thrombin was expressed in different degrees in brain tissue of 35 patients with intracerebral hemorrhage, the positive rate was 0.4686 ± 0.2739, the ICP (1d, 3d, 7d) was 309.71 ± 89.89mmH2O; 317.71 ± 103.95mmH2O; 275.00 ± 85.57mmH2O , And the GOS score was 2.91 ± 1.31. The positive rate of thrombin was moderately positive correlated with ICP (1d, 3d, 7d) (rS1 = 0.640, P <0.05; rS2 = 0.639, P < ), And had a moderate negative correlation with GOS score (rS4 = -0.800, P <0.05). Conclusion Thrombin is an important factor in the pathogenesis of cerebral edema after intracerebral hemorrhage and provides a clinical basis for the future treatment of cerebral edema with thrombin inhibitor.