目的:探讨脑出血急性期凝血机制的变化规律。方法:分别于发病12 h内和24 h采集65例急性期脑出血患者(观察组)静脉血,检测纤溶酶-抗纤溶酶复合物(plasmin-antiplasmin,PAP)、纤溶酶原激活剂抑制物(plasminogen activator inhibitor,PAI)、蛋白C(protein C,PC)、组织型纤溶酶原激活剂(tissue-type plasminogen activator,t-PA)和凝血酶抗凝血酶复合物(thrombin-antithrombin complex,TAT)水平,比较不同时间各项指标差异,并与同期50例健康体检者(对照组)进行比较。结果:观察组与对照组比较,TAT、t-PA、PC水平升高,PAP、PAI水平下降,2组比较差异有统计学意义(P<0.05);从发病12 h内到24 h,观察组患者TAT浓度升高后又有所下降,但仍高于对照组水平(P<0.05),其余指标变化差异无统计学意义(P>0.05)。结论:脑出血患者24 h内凝血功能处于亢进状态,伴继发性纤维蛋白溶解活性改变,血液呈低凝状态。 Objective: To investigate the changes of coagulation mechanism during acute cerebral hemorrhage. Methods: Venous blood of 65 patients with acute intracerebral hemorrhage (observation group) were collected within 12 h and 24 h of onset respectively. Plasmin-antiplasmin (PAP), plasminogen activator Plasminogen activator inhibitor (PAI), protein C (PC), tissue-type plasminogen activator (t-PA) and thrombin -antithrombin complex (TAT) were measured and compared with those of 50 healthy subjects at the same period (control group). Results: Compared with the control group, the levels of TAT, t-PA and PC were increased and the levels of PAP and PAI were decreased in the observation group and the control group (P <0.05). From the 12 hours of onset to 24 hours, The TAT concentration of patients in the group decreased afterwards but was still higher than that of the control group (P <0.05). There was no significant difference between the other indexes (P> 0.05). CONCLUSION: The intracerebral hemorrhage in patients with intracerebral hemorrhage in 24 h is hyperthyroidism, accompanied by changes in secondary fibrinolytic activity, the blood showed low coagulation status.