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目的 探讨溶栓治疗对纤维系统的影响以及各指标与临床疗效的关系。方法 本研究对９１ 例病后２４ ｈ 内就治的急性脑梗死随机分为４ 组，其中进行血样检测者对照组１４ 例，应用尿激酶（ＵＫ）６×１０５ Ｕ 组２２ 例，１６×１０５ Ｕ 组２２ 例，２６×１０５ Ｕ组１１ 例。在治疗前及治疗后２ ｈ、２４ ｈ、７～１０ 天（ｄ）进行组织型纤溶酶原激活物（ｔＰＡ）、纤溶酶原激活物抑制物（ＰＡＩ）、纤溶酶原（ＰＬＧ）、Ｄ－二聚体（Ｄ－Ｄ）检测。结果 对照组ｔＰＡ、ＰＡＩ、ＰＬＧ、Ｄ－Ｄ在治疗前及治疗后各时期无变化，溶栓治疗组于治疗后２ ｈ ｔＰＡ 及Ｄ－Ｄ明显升高，ＰＡＩ、ＰＬＧ下降。溶栓治疗并发出血的病例，于治疗后２４ ｈＰＡＩ仍明显降低。结论 溶栓治疗病例存在超早期纤维激活，凝血障碍是溶栓治疗并发出血的重要机制
Objective To investigate the influence of thrombolytic therapy on fibrosis and the relationship between each index and clinical efficacy. Methods In this study, 91 patients with acute cerebral infarction within 24 hours after treatment were randomly divided into 4 groups, of which 14 were blood samples control group, 22 patients were treated with 6 × 105 U of Urokinase group, 16 × 105 22 cases in U group and 11 cases in 26 × 105 U group. Tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI), plasminogen (PLG) and plasminogen activator inhibitor (PLG) were pretreated and at 2 h, 24 h and 7 ~ ), D-dimer (D-D). Results The levels of tPA, PAI, PLG and D-D in the control group did not change before and after treatment. The levels of tPA and D-D in the thrombolytic group were significantly increased at 2 h after treatment, while the levels of PAI and PLG in the control group decreased. Thrombolytic treatment of concurrent bleeding cases, 24 h after treatment, the PAAI was significantly reduced. Conclusion Thrombolytic therapy in patients with early ultra-early fiber activation, coagulation disorders is an important mechanism of thrombolytic therapy complicated by bleeding