高血压性脑出血急性期血浆D-二聚体、纤维蛋白原的变化及意义

Change and significance of D-dimer,FIB in plasma in acute phase of hypertensive cerebral hemorrhage

目的探讨高血压性脑出血(hypertensive cerebral hemorrhage,HICH)患者急性期血浆D-二聚体(D-dimer)、纤维蛋白原(fibrinogen,FIB)的动态变化及临床意义。方法采用磁珠法对60例高血压性脑出血患者血浆D-二聚体、FIB水平进行检测,并与40例健康人进行比较。结果高血压性脑出血患者发病后24小时及第3天,血浆D-二聚体水平显著升高,第3、7天纤维蛋白原水平显著升高,与正常对照组比较均有显著性差异(P<0·05)。预后不佳组血浆D-D水平明显升高,与预后佳组比较有显著性差异(P<0·01)。而且预后不佳组均为血肿破入脑室或蛛网膜下腔者。结论高血压性脑出血患者急性期血浆D-二聚体水平明显升高,提示在发病早期可能存在暂时性的、纤溶活性增高的倾向。血浆D-D水平的高低与出血部位、病人的预后有关。

Objective To investigate the dynamic change and clinical significance of plasma D-dimer, FIB levels of the patients with acute phase of hypertensive cerebral hemorrhage. Methods To detect the plasma D-dimer, FIB levels of the patients with hypertensive cerebral hemorrhage by magnetism pearls, and to compare with 40 healthy persons. Results The levels of D-dimer, FIB in plasma of the patients with hypertensive cerebral hemorrhage were higher on day 1, 3 and day 3, 7 respectively than those of in controls（ P 〈 0.05）. The groups of bad prognosis had significantly higher levels of D-dimer than those of good prognosis（ P 〈 0.01 ）. The patients of bad prognosis were almost sufferers that hacmatomata crashed through cerebral ventricle or subarachnoid cavity. Conclusion The plasma D-dimer levels of the patients with hypertensive cerebral hemorrhage are significantly high, indicating the possibility that the activation of fibrinolysis is inclined to increase in forepart. The plasma D-dimer levels of the patients with hypertensive cerebral hemorrhage correlate with the position of hemorrhage and prognosis.