| 重型颅脑损伤患者凝血纤溶系统标志物在脑动静脉中的变化 |
| 投稿时间：2014-08-08 修订日期：2014-09-16 点此下载全文 |
| 引用本文：马年斌,卢颖如,潘景业.重型颅脑损伤患者凝血纤溶系统标志物在脑动静脉中的变化[J].医学研究杂志,2015,44(3):128-131 |
| DOI：
10.3969/j.issn.1673-548X.2015.03.036 |
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| 中文摘要:目的 研究重型颅脑损伤患者局部与全身凝血纤溶系统标志物变化, 以进一步探讨在此类患者中是局部还是全身触发凝血系统障碍机制。方法 本研究收集自2010年9月~2013年6月入住笔者医院重症监护室(ICU)的56例重型颅脑损伤患者为实验组, 同期ICU住院的无凝血机制障碍的患者30例为对照组。予以颈内静脉置管收集脑静脉血液, 同时采集股动脉血标本, 分别于入院时、第1天、第2天、第3天检测凝血酶-抗凝血酶Ⅲ复合物(TAT)﹑凝血酶原片段1+2 (F1+2)、D2聚体﹑纤溶酶原活化剂抑制物-1(PAI-1)。结果 实验组中TAT、F1+2、D2聚体、PAI-1在研究各阶段均较参考值显著升高(P<0.01)。在入院时实验组中TAT、F1+2、 PAI-1有明显的经颅梯度变化(P<0.05)。结论 重型脑损伤后可能通过受损的脑组织血液部位激活凝血系统。 |
| 中文关键词:重型颅脑损伤 凝血 纤溶 |
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| Cerebral Local-systemic Coagulation Fibrinolysis System Markers Differences in Patients with Severe Traumatic Brain Injury |
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| Abstract:Objective To investigate the cerebral local-systemic coagulation fibrinolysis system markers differences in traumatic brain Injury patients. Methods Fiftysix patients with traumatic brain injury in ICU were studied at admittance to the hospital and during the next 3 days. We collected cerebrovenous blood samples from the internal jugular catheter and arterial blood. We measured concentrations of thrombin-antithrombinⅢ complex(TAT), D-dimer(D2), prothrombinfragment1+2(F1+2), Plasminogen activator inhibitor-1, PAI-1. Results Levels of D-D, TAT F1+2, and PAI-1 were significantly increased shortly after the trauma compared to reference values, with considerable transcranial gradients for TAT, F1+2and PAI-1. Conclusion We conclude that activation of the coagulation system takes place during the passage of blood through the damaged brain, and is already evident hours after the trauma. |
| keywords:Severe traumatic brain injury Coagulopathy Fibrinolysis |
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