Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Stroke. 2010 Dec;41(12):2976-8. doi: 10.1161/STROKEAHA.110.595868.
We tested the hypothesis that proteins of hemostasia could be associated with hematoma growth (HG) in patients with acute intracerebral hemorrhage.
We prospectively studied patients with spontaneous supratentorial intracerebral hemorrhage within the first 6 hours after the onset of symptoms. HG was defined as an increase > 33% in the volume of hematoma on CT obtained 24 to 72 hours after the onset of symptoms in comparison with the CT obtained at admission. We collected admission and follow-up blood samples. We measured fibrinogen, factor XIII, thrombin activatable fibrinolysis inhibitor, plasminogen activator inhibitor, plasminogen, α₂-antiplasmin, tissue plasminogen activator, d-dimer, thrombomodulin, thrombin-antithrombin complex, and plasmin-antiplasmin complex.
We included 90 patients with a mean age of 71 ± 10.8 years; 61% were men. HG was observed in 35 (39%) of the patients. Mean baseline and follow-up protein measurements showed no difference between the groups with and without HG. The analysis of variance showed that factor XIII activity decreased in the non-HG group in the 24 to 72 hours sample, whereas it increased in the HG group (P = 0.001).
Factor XIII was the only measured protein related to HG. The levels at the follow-up sample decreased in the non-HG group and increased in the HG group. Further studies are needed to confirm this association.
我们检验了这样一个假设，即止血蛋白可能与急性脑出血患者的血肿增大（HG）有关。
我们前瞻性地研究了症状发作后 6 小时内发生的自发性幕上脑出血患者。HG 的定义为与入院时 CT 相比，症状发作后 24 至 72 小时获得的 CT 显示血肿体积增加>33%。我们收集了入院时和随访时的血液样本。我们测量了纤维蛋白原、因子 XIII、凝血酶激活的纤溶抑制物、纤溶酶原激活物抑制剂、纤溶酶原、α₂-抗纤溶酶、组织型纤溶酶原激活物、D-二聚体、血栓调节蛋白、凝血酶-抗凝血酶复合物和纤溶酶-抗纤溶酶复合物。
我们纳入了 90 例平均年龄为 71±10.8 岁的患者；61%为男性。35 例（39%）患者出现 HG。HG 组和非 HG 组之间，基线和随访时的蛋白测量均值无差异。方差分析显示，非 HG 组在 24 至 72 小时样本中因子 XIII 活性降低，而 HG 组则升高（P=0.001）。
因子 XIII 是唯一与 HG 相关的测量蛋白。非 HG 组在随访样本中的水平下降，而 HG 组则升高。需要进一步研究来证实这种关联。
