Itoyama Y, Fujioka S, Takaki S, Morioka M, Hide T, Ushio Y
Section of Neurosurgery, Saiseikai Kumamoto Hospital, Japan.
Neurosurgery. 1994 Dec;35(6):1055-60. doi: 10.1227/00006123-199412000-00006.
Thrombin-antithrombin III complex (TAT) and plasmin-alpha 2-plasmin inhibitor complex (PIC) were examined in the acute stage in 51 patients with nontraumatic subarachnoid hemorrhage. TAT and PIC values were correlated with severity at the time of onset and with outcome. In the patients whose TAT levels were 25 ng/ml or more and PIC levels were 3.0 micrograms/ml or more (n = 16), only 25% had a good or fair outcome. In the patients with TAT levels less than 25 ng/ml or PIC levels less than 3.0 micrograms/ml (n = 35), on the other hand, 82.9% had a good or fair outcome. There were no significant differences in TAT and PIC levels between patients who experienced arterial spasm and those who did not. These results indicate that TAT and PIC values may reflect the severity of the brain damage induced by subarachnoid hemorrhage. It is speculated that marked coagulation and fibrinolytic disorders occur in the acute stage of subarachnoid hemorrhage.
对51例非创伤性蛛网膜下腔出血患者急性期的凝血酶 - 抗凝血酶III复合物（TAT）和纤溶酶 - α2 - 纤溶酶抑制物复合物（PIC）进行了检测。TAT和PIC值与发病时的严重程度及预后相关。在TAT水平≥25 ng/ml且PIC水平≥3.0 μg/ml的患者（n = 16）中，仅有25%预后良好或尚可。另一方面，在TAT水平＜25 ng/ml或PIC水平＜3.0 μg/ml的患者（n = 35）中，82.9%预后良好或尚可。发生动脉痉挛的患者与未发生动脉痉挛的患者之间，TAT和PIC水平无显著差异。这些结果表明，TAT和PIC值可能反映蛛网膜下腔出血所致脑损伤的严重程度。据推测，蛛网膜下腔出血急性期会发生明显的凝血和纤溶障碍。
