Clinical Study Of TpP Changes In Patients With Ischemic Cerebrovascular Disease

Thrombosis disease is first reason for high morbidity and lethality in developed country,at present, they are rising in china . ischemia cerebrovascular disease(ICD)which include TIA and cerebral infarction is common in clinic, 65% of acute cerebral infarction is occupied by cerebral thrombosis,it's pathogenesis mostly include artery tube stricture and thrombosis. Wherefore,it is important to early diagnosis,monitoring state of illness change and supervise cure that exploring celerity detection indices in thrombosis.Thrombus precursor Protein (TpP) is a high molecular soluble fibrin polymer.they are intermediate product in the process that desAA fibrin monomer (FM)convert insolubility fibrin polymer.dessAA fibrin monomer unit is that zymoplasm cut fibinopeptideA fromα-chain of fibrinogen,then dessAA fibrin monomer could get together each other because of ploymerize site,and then form dimer, trimer and multimer.At the same time, zymoplasm cut fibinopeptideB fromβ-chain of fibrinogen,finally formation dessAABB polymer, all of these soluble fibrin is TpP.Study the change of TpP content in plasma with ischemic cerebrovascular disease can help us early diagnosis,monitor the patient's condition and then guide strategy.we detected PT, APTTand the content of Fib,TpP in plasma for acute cerebral infarction(ACI) and TIA patients,observe the change of Fib and TpP at different time,at the same time.observed the effects of Batroxobin Injection.,then make clinical approach for the valuble of TpP,and then offer theoretical foundation for diagnosis and treatment of ICD.We choose 57 patients with ICD,ACI patients whose onset duration were between 6～48 hours are 34,according to onset time grouping,TIA patients who were in period of onset are 23, according to whether or not existing focus of infection grouping.All case come from 2006.7～2007.3 at the department of neurology in China Japan Union Hospital of Jilin University,all of them accord with the diagnositic standard of national fourth Meeting of cerebrovascular disease in 1996.Adopt ELISA quantitative method measure TpP consent in plasma of 57 patients and 15 normal ,at the same time,Adopt turbidimetric method measure PT,APTT and Fib.15 ACI patients accept drop fibrinogen treatment with Batroxobin Injection,observe its influence to Fib and TpP content ,and make correlation analysis between Fib and TpP. The result show, TpP detection positive incidence rate is apparently higher than PT,APTT and Fib at onset earlier period of Acuteness cerebral infarction patients.the content of TpP is tallist within 6 hours. The content of TpP and Fib both are descend after treatment,the content of Fib prior treatment is higher than post-treatment and control group's(CG),and the content of CG is higher post-treatment's.the content of prior treatment is higher than both post-treatment and CG's,although the content of post-treatment have descended obviously,it is still higher than CG.correlation analysis show ,the content of TpP in plasma of ACI patients has positive correlation with Fib.,the content of TpP compare among ACI,TIA, CG, ACI group is higher than TIA,and TIA group is higher than CG,TIA with focus of infection is higher than without.At present, PT, APTT, TT, Fib and D-D are commonly used to monitoring blood clotting and fibrinolysin state in clinical.PT,APTT have not marked change for ACI patients.Fib is chief ground-substance of thrombotic. Hypsifibrinogen could promote fibrious formation, which is one of main referred indicatrix.the key point of thrombotic is that soluble fibrin change into unsoluble fibrin polymer,TpP is a kind of important thig in the process,it will unavoidable increasing.Pay attention that TpP is a thing between Fib and thrombotic,so the danger of thrombotic will increase with content increasing of TpP.Study show not only the content of TpP increase in plasma with ICD,but also Fib increase.Fib obviously next to TpP which is the most sensitive and characteristic index among our detection.Following thromb formation , TpP convert insolubility thing, its content will degrade in plasma. Finding show the content of TpP reach peak within 6 hours,then gradually descend.it hint that TpP can as a laboratory diadynamic criteria for ACI.we also find that the content of TpP in plasma with ACI parients is higher than TIA's, and then the content of TIA with focue of infection is higher than TIA without infection.it Hint that TpP can monitor patient's condition change as laboratory index.Treatment of drop Fib take important role of treatment. Batroxobin Injection could cut down Fib directly and remarkably, further degrade TpP formation ground-substance,thromb formation is inhibited.our finding show TpP descend obviously after treatment,but due to TpP get together endlessly,TpP also could cut down without any treatment,so the reason of descending is not clear completely.In summary, we come to following conclusions: blood clotting index compare with TpP in acute cerebral infarction,the masculine rate of TpP and Fib higher than others,TpP more obviously.the content of TpP change kinesisly,and reach peak within onset 6 hours.correlation analysis show, the content of TpP in plasma of ACI patients has positive correlation with Fib.Fib and TpP both descend after treatment of droping fibrin. ,the content of TpP compare among ACI,TIA, CG, ACI group is higher than TIA,and TIA group is higher than CG,TIA with focus of infection is higher than without. Hint TpP can early diagnosis,monitoring state of illness change and supervise cure as laboratory index for ICD.