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目的观察脑梗死（ＣＩ）患者血浆纤溶酶－α２－抗纤溶酶复合物（ＰＡＰ）、凝血酶－抗凝血酶Ⅲ复合物（ＴＡＴ）测定和外周血单核细胞（ＰＢＭＣ）组织因子（ＴＦ）及ｔ－ＰＡ：ａ和ＰＡＩ：ａ的变化及其意义。方法分别应用ＥＬＩＳＡ法、凝血酶和反应法发色底物法测定５０例脑梗死患者、２０例健康对照及２０例非血栓疾病病例对照的血浆ＰＡＰ、ＴＡＴ、Ｆｇｎ含量、ＰＢＭＣＰＣＡ、ＰＢＭＣＴＰＡ和ＰＡＩ活性。结果①脑梗死患者血浆ＰＡＰ、ＴＡＴ及Ｆｇｎ水平明显增高，与病例对照组及正常对照组比较均有显著差异；②脑梗死患者ＰＢＭＣＴＦ活性明显高于健康对照组（Ｐ＜０．０１）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣｔ－ＰＡ活性表达明显低于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。ＰＢＭＣＰＡＩ活性明显高于健康对照组（Ｐ＜０．０５）及病例对照组（Ｐ＜０．０１）。结论血浆ＴＡＴ及ＰＡＰ水平检测可较好的评价脑梗死患者凝血及纤溶系统激活状态。脑梗死患者在细胞水平已处于高凝状态。并在细胞水平存在凝血与纤溶系统失衡。
Objective To observe the levels of plasma plasminogen-α2-anti-plasmin complex (PAP), thrombin-antithrombin Ⅲ complex (TAT) and peripheral blood mononuclear cells (PBMC) tissue factor in patients with cerebral infarction (TF) and t-PA: a and PAI: a changes and its significance. Methods The plasma levels of PAP, TAT, Fgn, PBMCPCA, PBMCTPA and PAI in 50 patients with cerebral infarction, 20 healthy controls and 20 non-thromboembolic diseases were determined by ELISA, thrombin and chromogenic substrate method respectively . Results ① The plasma levels of PAP, TAT and Fgn in patients with cerebral infarction were significantly higher than those in the control group and the normal control group. ② The activity of PBMCTF in patients with cerebral infarction was significantly higher than that in healthy controls (P <0.01) Control group (P <0.01). The activity of PBMCt-PA was significantly lower than that of the healthy control group (P <0.05) and the case control group (P <0.01). PBMCPAI activity was significantly higher than the healthy control group (P <0.05) and the case control group (P <0.01). Conclusion Plasma TAT and PAP levels can be used to evaluate the activation of coagulation and fibrinolytic system in patients with cerebral infarction. Patients with cerebral infarction have been hypercoagulable at the cellular level. There is an imbalance between coagulation and fibrinolysis at the cellular level.