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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。
Objective: To investigate the changes and clinical significance of Hcy, ET-1, hs-CRP, TXA2 levels and coagulation and fibrinolysis indexes in patients with acute cerebral infarction (ACI) before and after treatment. Methods: The levels of Hcy, ET-1, hs-CRP, TXA2 and coagulation and fibrinolysis indexes in 68 patients with ACI before and after treatment were detected by ELISA, chromogenic substrate, thrombin, radioimmunoassay Level of detection, and 30 normal healthy people as a control group. Results: ① The levels of plasma Hcy, ET-1, hs-CRP and TXA2 in patients with ACI before treatment were significantly higher than those in the control group (P <0.01). After treatment, the levels of Hcy and ET-1 returned to normal, (P> 0.05). ② The content of plasma ET-1, serum hs-CRP and TXA2 in mild, moderate and severe groups increased gradually with significant difference between the two groups (P <0.01 or 0.05 ), While the plasma Hcy level was significantly higher in moderate-severe patients than in light-duty patients (P <0.01). ③ After treatment, the levels of plasma vWF, GMP-140, Fg and F1 + 2 in ACI patients decreased significantly compared with those before treatment, but the plasma PS activity, PC activity and AT levels were significantly increased (P <0.01) There was no significant difference between PC activity and control group (P> 0.05). The level of tPA in the plasma of patients with ACI was lower than that of the control group, and the content of plasma PAI-1 was higher than that of the control group (P <0.01). After treatment, plasma tPA increased and there was no significant difference between the two groups (P> 0.05). PAI-1 decreased but remained significantly higher than that of the control group (P <0.05). Conclusion: The changes of Hcy, ET-1, hs-CRP, TXA2 and coagulation and fibrinolysis indexes in patients with acute cerebral infarction (ACI) have important clinical significance in guiding medication, observation of disease and prognosis.