急性脑梗死患者D二聚体、纤维蛋白原及血小板参数的变化

Changes of Plasma D-dimer,Fibrinogen and Platelet Parameters in Patients with Actue Cerebral Infarction

目的探讨急性脑梗死患者血浆 D 二聚体(D-D)、纤维蛋白原(Fbg)含量及全血血小板5项参数的变化及其临床意义。方法选自2002年9月至2004年1月在我院神经内科收治的急性脑梗死患者53例。患者在发病后24h 内抽肘静脉血抗凝。测定其血浆 D-D、Fbg 含量及全血血小板数(PLT)、平均血小板体积(MPV)、血小板体积分布宽度 (PDW)、血小板比积(PCT)、大血小板比率(P-LCR),并与50例健康对照组进行比较。患者和对照组均未接受任何止血、凝血药物。结果急性脑梗死患者血浆 D-D、Fbg 含量显著高于对照组(P＜0.01)；PLT 明显低于对照组(P＜0.01)；MPV、 PDW、P-LCR 显著高于对照组(P＜0.01),PCT 两组间无明显差异。结论血浆 Fbg 含量升高和 MPV 增大是脑梗死的重要危险因素,观察 D-D、Fbg、PLT、MPV、PDW 及 P-LCR 的变化对脑梗死的诊断和病情判断具有重要的指导意义。

Objective To investigate the changes and its clinical significance of plasma D-dimer（ D- D）, fibrinogen（Fbg） and platelet parameters in patients with acute cerebral infarction. Methods The blood samples of 53 acute cerebral infarction patients with 24 hours of onset were collected from Sep 2002 to Jan 2004 in our hospital. The contents of D-D, Fbg, platelet count（ PLT）, mean platelet volume （MPV）, platelet volume distribution width （PDW） , plateletcrit （PCT） and platelet large cell ratio （P-LCR） were determind and compared with 50 cases of the control group. Results In patients with acute cerebral infarction ,the plasma contents of D-D and Fbg were significantly higher than those in control group （P 〈 0.01 ） ;PLT was significantly less than that in the control group （P 〈 0.01 ） ;MPV, PDW and P-LCR were significantly higher than that in the control group（ P 〈 0.01 ） but there was no significant difference in PCT between the two groups. Conclusion The increasments of Fbg and MPV are the important dangerous factors of acute cerebral infarction. Observing the changes of the D-D,Fbg, PLT, MPV, PDW and P-LCR is important to dignose and judge the prognosis in these patients.