纤溶酶原激活物抑制物-1与急性脑梗死并发急性肺损伤/急性呼吸窘迫综合征的相关性研究

Research on correlation between complicated acute lung injury/acute respiratory distress syndrome and plasminogen activator inhibitor-1 in patients with acute cerebral infarction

摘要: 目的探讨急性脑梗死并发急性肺损伤/急性呼吸窘迫综合征患者血清纤溶酶原激活物抑制物-1(PA1-1)水平变化及临床意义.方法采用前瞻性研究方法,收集急性脑梗死并发ALI/ARDS患者28例,单纯ALI/ARDS患者26例,健康对照组20例.根据脑梗死部位不同,A组被进一步分为前循环区组(5例)、后循环区组(15例)、分水岭区组(8例).所有研究对象均已行头颅CT/MRI检查.A、B组行APACHEⅡ评分.检测所有患者血清PAI-1水平,比较各组PAI-1水平变化及其与APACHEⅡ评分相关性.结果脑梗死并发ALI/ARDS组、单纯ALI/ARDS组PAI-1水平高于对照组(P＜0.01),脑梗死并发ALI/ARDS组高于单纯ALI/ARDS组(P＜0.05).后循环梗死患者ALI/ARDS发生率最高(53.57％).血清PAI-1水平与APACHEⅡ评分呈正相关(P＜0.01).结论 ALI/ARDS存在凝血纤溶功能障碍,脑梗死(尤其后循环区梗死)更易致ALI/ARDS的发生,PAI-1水平可预示疾病的严重程度.