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目的 :研究急性脑梗死应用大剂量尿激酶 (urokinase ,UK)溶栓治疗前后凝血和纤溶系统的变化 ,为预防脑出血和溶栓治疗后抗凝治疗提供了理论依据。方法 :急性脑梗死 2 2例 ,病程 6～ 12小时经头颅CT证实。检测患者入院后即刻和溶栓后 30min、1h、2h、3h、4h、6h、1d、3d凝血酶时间 (TT)、凝血酶原时间 (PT)、部分活化凝血活酶时间 (ATPP)、纤维蛋白 (原 )含量 (FIB)。纤溶指标 :D 二聚体 (D Dimer) ,纤维蛋白降解产物 (FDP)进行动态观察。结果 :UK溶栓后机体凝血系统和继发性纤溶系统均有明显变化。呈低凝、高纤溶状态。结论 :TT、PT、FIB、D Dimer、FDP可作为溶栓过程中常规监测指标。溶栓 2 4h后可加用抗凝治疗。
Objective: To study the changes of coagulation and fibrinolysis system before and after thrombolytic therapy with high dose urokinase (UK) in patients with acute cerebral infarction, and to provide a theoretical basis for preventing anticoagulant therapy after cerebral hemorrhage and thrombolytic therapy. Methods: Acute cerebral infarction in 22 cases, duration of 6 to 12 hours by head CT confirmed. Thrombin time (TT), prothrombin time (PT), partial activated thromboplastin time (ATPP), fibrinolytic activity and fibrinolytic activity were measured immediately after admission and at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, Protein (original) content (FIB). Fibrinolytic index: D Dimer, fibrin degradation products (FDP) for dynamic observation. Results: There was a significant change in the coagulation system and secondary fibrinolytic system in the UK after thrombolysis. Was low-coagulation, high fibrinolytic state. Conclusion: TT, PT, FIB, D Dimer, FDP can be used as routine monitoring indicators during thrombolysis. Thrombolysis can be added after 2 4h anticoagulant therapy.