多项实验室指标与急性脑梗死的关系

Relationship between multiple laboratory markers and acute cerebral infarction:a retrospective case-control study

目的探讨同型半胱氨酸(Hcy)、D-二聚体(D-D)、纤维蛋白原(FIB)、超敏C-反应蛋白(hs-CRP)及血脂水平与急性脑梗死(ACI)的关系。方法选择2014年8月至2015年10月钦州市第一人民医院神经内科收治ACI患者(发病时间小于或等于72h)288例作为梗死组,根据患者头颅CT和(或)MRI表现分为以下4个亚组:大梗死组46例,中梗死组97例,小梗死组106例及腔隙性梗死组39例;选取同期该院健康体检者100例作为对照组。分别测定各组对象的血清Hcy、总胆固醇(CHO)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血浆D-D、FIB及全血hs-CRP水平。结果梗死组其原发性高血压、糖尿病、冠心病、吸烟及饮酒比例显著高于对照组(P<0.05),而且梗死组Hcy、D-D、FIB及hs-CRP水平均高于对照组(P<0.05),而CHO、HDL-C及LDL-C水平与对照组差异无统计学意义(P>0.05)。大梗死组、中梗死组、小梗死组血清Hcy水平均高于腔隙性梗死组(P<0.05);大梗死组血浆D-D及FIB水平高于中梗死组、小梗死组及腔隙性梗死组(P<0.05);大梗死组、中梗死组全血hs-CRP水平高于小梗死组及腔隙性梗死组(P<0.05)。结论 Hcy、D-D、FIB及hs-CRP水平上升可能是广西北部湾地区人群ACI的危险因素,联合检测以上4个指标对ACI的早期诊断具有重要意义。

Objective To explore the relationship between homocysteine（Hcy）,D-dimer（D-D）,fibrinogen（FIB）,high sensitive C-reactive protein（hs-CRP）,cholesterol（CHO）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）and acute cerebral infarction（ACI）.Methods A total of 288 patients with ACI which were divided into large-area infarction group（46cases）,medium-area infarction group（97cases）,106 patients with small-area infarction group（106cases）and lacunar infarction group（39cases）were selected as subjects from August 2014 to October 2015 as well as 100 healthy controls were enrolled for this study.Plasma D-D and FIB,serum Hcy,CHO,HDL-C and LDL-C as well as the whole blood hs-CRP levels were measured.Results The ratio of patients with hypertension,diabetes,coronary heart disease,smoking and alcoholism were significantly higher than healthy controls（P〈0.05）.The levels of Hcy,D-D,FIB,and hs-CRP in patients with ACI were significantly higher than healthy controls（P〈0.05）,but the levels of CHO,HDL-C and LDL-C were not different with the control group（P〉0.05）.The serum Hcy level in patients with large-area,medium-area and small-area infarction group were significantly higher than that of lacunar infarction group（P〈0.05）.The D-D and FIB levels in large-area infarction group were significantly higher than that of medium-area,small-area and lacunar infarction group（P〈0.05）.The hs-CRP level in patients with large-area and medium-area infarction group were significantly higher than that of small-area and lacunar infarction group（P〈0.05）.Conclusion High levels of Hcy,D-D,FIB,and hs-CRP may be the risk factors of patients with ACI in Guangxi.Combined detection of the four indicators may contribute to the early diagnosis of ACI.