Changes And Clinical Significance Of TF And TFPI In Diabetic Stroke

Objective:Tissue factor (TF) is a membrane-bound procoagulant glycoprotein. It is the initiator of the extrinsic clotting cascade, which plays an important role in physiological hemostasis and pathologic thrombosis. Tissue factor pathway inhibitor (TFPI), a anticoagulation protein in-vivo, is the only physiological inhibitor of TF-induced coagulation, which can regulate the activity of TF, while it mainly functions in preventing thrombosis and vascular-remodeling. To a cetain extent, TF/TFPI ratio can reflect the balance between procoaglation and anticoaglation or not. It particularly works in the normal flow of blood. The purpose of this research involves three aspects:Firstly, to investigate the change of serum TF and TFPI in acute diabetic stroke patients. Secondly, to study the relationship between the infarction area and the neurologic impairment score and levels of TF and TFPI. Thirdly, to see the possible mechanisms of diabetic stroke from clotting aspects and provide a theoretical basis for anticoagulant treatment of patients with diabetic stroke.Methods:60 cases of acute brain infarction and 30 cases of out-patient volunteers were enrolled in this experiment. They were all from the First Hospital of Lanzhou University during the period of January 2010 to August 2010. Depending on whether associated with diabetes, the infarction patients were divided into two groups:the diabetic stroke group and the nondiabetic one. Serum TF and TFPI levels were measured by ELISA. The area of brain infarction on computed tomographic (CT) scan in acute infarction patients were determined at 72 hours after the stroke onset. At the same time, neurologic impairment score were assessed too.Results:Firstly, the levels of serum TF and TFPI in acute cerebral infarction patients was conspicuously higher than the control group (P<0.05). Secondly, compared with the nondiabetic stroke group, not only showed diabetic stroke group higher levels of TF and TFPI(P<0.05), but also higher ratio of TF/TFPI (P<0.05). Thirdly, neither the infarction area nor the neurologic impairment score were found obvious correlation with TF and TFPI levels.Conclusion:There was no clearly correlation between the levels of two factors (TF and TFPI) with severity of acute cerebral infarction. But the levels of serum TF and TFPI in acute cerebral infarction patients was conspicuously higher, it indicated the TF and TFPI had taken part in the pathological process of acute cerebral infarction. Meanwhile, higher levels of TF and TFPI could be found in diabetic stroke patients, it suggested that there was a more serious coagulation disorder in diabetic stroke patients. Lastly, the imbalance of the TF/TFPI ratio leads to hypercoagulability.