Fon E A, Mackey A, Côté R, Wolfson C, McIlraith D M, Leclerc J, Bourque F
Department of Neurology and Neurosurgery, Montreal General Hospital, McGill University, Quebec, Canada.
Stroke. 1994 Feb;25(2):282-6. doi: 10.1161/01.str.25.2.282.
Hemostatic abnormalities have been shown previously in stroke patients. The purpose of this study was to assess the activity of selected parameters of the coagulation system in acute reversible cerebral ischemia.
We measured fibrinopeptide A, thrombin-antithrombin III, and D-dimer in 36 patients in both the acute (< 7 days) and postacute stage (1 and 3 months) after a transient ischemic attack (TIA). The results were compared with those of 20 asymptomatic patients with a history of remote TIA and 65 age- and sex-matched controls.
Mean fibrinopeptide A and thrombin-antithrombin III values were elevated in the acute stage after a TIA (P < .02) compared with levels at 1 month. In contrast, D-dimer was significantly increased at all three times points after the event when compared with remote TIA (P < .05) or control subjects (P < .001). No association could be found between marker levels and clinical outcome or the degree of cervical atherosclerosis as assessed by duplex ultrasonography.
These findings suggest that after acute reversible cerebral ischemia, there is early transient activation of thrombogenesis and ongoing fibrinolysis.
先前已证实中风患者存在止血异常。本研究旨在评估急性可逆性脑缺血时凝血系统特定参数的活性。
我们测定了36例短暂性脑缺血发作（TIA）患者急性（<7天）和急性后期（1个月和3个月）的纤维蛋白肽A、凝血酶 - 抗凝血酶III及D - 二聚体。将结果与20例有既往TIA病史的无症状患者以及65例年龄和性别匹配的对照者的结果进行比较。
与1个月时的水平相比，TIA后急性期的纤维蛋白肽A和凝血酶 - 抗凝血酶III的平均水平升高（P <.02）。相比之下，与既往TIA（P <.05）或对照者（P <.001）相比，事件发生后的所有三个时间点D - 二聚体均显著升高。通过双功超声评估，标志物水平与临床结局或颈部动脉粥样硬化程度之间未发现关联。
这些发现表明，急性可逆性脑缺血后，存在血栓形成的早期短暂激活和持续的纤维蛋白溶解。
