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中华神经创伤外科电子杂志 ›› 2025, Vol. 11 ›› Issue (04) : 264 -269. doi: 10.3877/cma.j.issn.2095-9141.2025.04.009

综述

新型血栓标志物在神经外科重症领域中的应用
张子谦, 王娜, 赵浩()   
  1. 100053 北京,首都医科大学宣武医院神经外科
  • 收稿日期:2025-04-08 出版日期:2025-08-15
  • 通信作者: 赵浩

Application of novel thrombosis markers in neurosurgical critical care

Ziqian Zhang, Na Wang, Hao Zhao()   

  1. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2025-04-08 Published:2025-08-15
  • Corresponding author: Hao Zhao
  • Supported by:
    Beijing Municipal Hospital Scientific Research Cultivation Program(PX2025074)
引用本文:

张子谦, 王娜, 赵浩. 新型血栓标志物在神经外科重症领域中的应用[J/OL]. 中华神经创伤外科电子杂志, 2025, 11(04): 264-269.

Ziqian Zhang, Na Wang, Hao Zhao. Application of novel thrombosis markers in neurosurgical critical care[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2025, 11(04): 264-269.

凝血与纤溶失衡是神经外科重症(如颅脑外伤、颅内出血、脑肿瘤)围术期并发症的关键诱因,而新型血栓标志物(凝血酶-抗凝血酶复合物、纤溶酶-α2-纤溶酶抑制剂复合物、组织型纤溶酶原激活剂-抑制剂复合物及血栓调节蛋白)可早期、敏感监测凝血激活、纤溶活性及内皮损伤,为围术期诊断、治疗策略调整(如抗凝或抗纤溶治疗)提供依据,并有助于预测血栓及再出血等风险。本文旨在明确新型标志物在神经外科重症精准诊疗中的价值,剖析当前应用局限,并提出未来研究方向,以期为优化围术期管理、减少继发性脑损伤、改善预后提供理论依据,也为后续研究提供方向性参考。

Imbalance between coagulation and fibrinolysis is a key inducer of complications in neurosurgical critical care (such as traumatic brain injury, intracranial hemorrhage, and perioperative period of brain tumors). Novel thrombosis markers (thrombin-antithrombin complex, plasmin-α2-plasmin inhibitor complex, tissue-type plasminogen activator-inhibitor complex, and thrombomodulin) can monitor coagulation activation, fibrinolytic activity, and endothelial injury in an earlier and more sensitive manner. They provide a basis for diagnosis and treatment adjustment (e.g., anticoagulant or antifibrinolytic regimens) and also help predict risks such as thrombosis and rebleeding. The purpose of this review is to clarify the value of these novel markers in the precise diagnosis and treatment of neurosurgical critical care, analyze current application limitations, and propose future research directions. It aims to provide theoretical references for optimizing clinical patient management, reducing secondary brain injury, and improving prognosis, as well as offer directional references for subsequent research.

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