目的 探讨脑室出血后脑室系统是否具有纤溶能力及应用外源性尿激酶(UK)是否有助于增强纤溶的活性.方法 34例脑室出血患者,其中17例患者行侧脑室穿刺外引流,为no-UK组;另17例患者行侧脑室穿刺外引流+尿激酶脑室内灌注治疗,为UK组.采用ELISA法测量穿刺后0、2、4、6、12 h点脑脊液标本中D-二聚体(D-D)含量.结果 no-UK组脑脊液中D-D含量随时间而增加,相邻2个时间点间比较P<0.05;UK组5个时间点脑脊液D-D含量进行两两比较,与0 h点比较,2、4 h点显著升高(P<0.01),6、12 h点仍高于0 h点(P<0.05).两组间D-D含量在2 h(P<0.01)和4 h(P<0.05)时比较差异有统计学意义,0、6、12 h时比较差异无统计学意义(P>0.05).重复测量数据的方差分析显示时间因素、时间因素与分组因素的交互作用、分组因素均有统计学意义.结论 脑室出血后脑脊液中D-D含量随时间增加,且可被外源性UK的应用而增强,表明在脑室出血后的脑室系统内应用UK是可行的.%Objective To investigate whether ventricular systems has fibrinolytic ability after intravent-ricular hemorrhage( IVH )and whether application of exogenous urokinase( UK )help to enhance the fibrinolytic activity. Methods 34 severe IVH patients with the treatment of external ventricular drainage( EVD ) were randomly divided into two groups,UK group and no-UK group. In UK group,all patients were treated with EVD and intraventricular infusion of urokinase, but in no-UK group, patients with only EVD. The CSF samples 2 ml were obtained at 0,2,4,6 and 12 h after operation of EVD to test the D-dimer( D-D )fcontent by ELISA method. Results In no-UK group,the contents of D-D in CSF increased with time,the differences were significant between each neighbour time-point( P <0. 05 ). In UK group,the contents of D-D at 2,4h points increased significantly when compared with that at 0h( P <0. 01 ),the levels of D-D at 6h and 12h were still higher than that at 0h( P < 0. 05 ). At the same time points, the levels of D-D were significantly higher at 2,4h point in UK group than in no-UK group( P <0. 05 ),while there were no significant differences between two groups at 0,6,12h point( P > 0.05 ). Repeated measures ANOVA results showed that time factors,time x group,group factor all had statistical significance. Conclusion The contents of D-D increases in CSF after IVH and can be enhanced by an intraventricular infusion of exogenous urokinase, which suggests that it is feasible to treat IVH patients with urokinase.
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