缺血性脑梗死患者D-二聚体定量检测的临床研究

Clinical study of quantitative detection of D-dime in plasma of patients with cerebral ischemic infarction

目的:了解缺血性脑梗死患者在不同阶段血浆D-二聚体测定的意义.方法:随机选择42例到本院神经内科就诊的缺血性脑梗死患者(年龄53～90岁,男21例,女21例),分别于急性期(＜6天,n=27,年龄53～87岁)和亚急性期(6～20天,n=15,年龄51～90岁)行血浆D-二聚体测定.患者均经头颅CT证实为缺血性脑梗死.同时选择年龄相匹配的20例其他非凝血及血栓性疾病患者(年龄61～87岁)作为对照组.结果:缺血性脑梗死患者的血浆D-二聚体水平在急性期未见升高(＜0.5 mg/L),而在亚急性期显著升高(≥0.5 mg/L,0.5～2 mg/L),亚急性期与对照组(＜0.5mg/L)比较差异有显著性(P＜0.001),与急性期比较差异也有显著性(P＜0.001)(正常值为＜0.5mg/L).结论:缺血性脑梗死患者的纤溶系统显著激活并非在急性期,而是在亚急性期.这也为急性期进行溶栓治疗提供了依据.

Objective： The purpose of this study was to clarify differences in fibrinolytic activation among the various phases of cerebral ischemic infarction.Methods：D - dimer were measured in 42 patients with cerebral ischemic infarction（51 ～ 90 years, men 21, female 21） and 20 age - matched controls. All 42 patients were divided into two groups, 27 cases were during acute phases（ 〈 6 days） and 15 cases were during subacute phases （ 6 ～ 20 days ）. Results： The levels of D - dimer were significantly higher （ ≥ 0.5 mg/L, 0.5 - 2 mg/L） during subacute phases of cerebral ischemic infarction than those in the controls （ 〈 0.5 mg/L, P 〈 0. 0001）, however, the levels of D - dimer were not elevated （ 〈 0.5mg/L）during the acute phases of cerebral ischemic infarction （normal was 〈 0.5 rag/L）, which were less than those during subacute phases（ P〈 0.0001） .Conclusion： Our findings suggested that fibrinolytie activations were significantly increased during subacute phases of cerebral ischemic infarction, and were not increased during acute phase.