血浆D-二聚体动态变化对急性脑梗死患者预后的影响

The Fluctuation of Plasma D-Dimer Level in Patients with Cerebral Infarction and Its Significance in Prognosis Judgement

目的探讨脑梗死病人血浆D-二聚体的动态变化及对预后的影响。方法采用散射比浊法检测67例脑梗死病人急性期和恢复期的血浆D-二聚体水平,以50名健康自愿者为对照。根据恢复期血浆D-二聚体水平与急性期相比下降是否超过一个急性期标准差(脑梗死组患者急性期血浆D-二聚体的标准差,本实验为0.325)将病人分为下降组和稳定组,分别对其预后进行观察和比较。结果脑梗死病人急性期的血浆D-二聚体水平与对照组比较明显升高,差别有统计学意义(P<0.01)。脑梗死病人恢复期血浆D-二聚体水平比急性期时下降者预后良好,稳定者预后不良(P<0.01)。结论脑梗死病人急性期和恢复期血浆D-二聚体水平的变化可较直接地反映机体的凝血、继发性纤溶状态和病情的变化,对诊断和预后判断有一定的指导意义。

Objective To explore the fluctuation of plasma D-dimer level of acute phase and con- valescence phase and its significance in the prognosis in cerebral infarction. Methods The plasma Ddimer of patients with cerebral infarction（n=67） in acute phase and convalescence phase as well as normal humans（n=50） were assayed with scatter nephelometer method. According to the plasma D-dimer level in convalescence phase descends ls（in this experiment was 0. 325） than those in acute phase, the patients were separated into two groups, observe and compared the prognosis of two groups. Results The patients in acute phase compared with normal control group, D-dimer level was very significantly different [（0. 984±0. 325） vs （0. 375±0. 128） μg/mL （P〈0.01）-]. The group whose plasma D-dimer were descend in convalescence phase which imply better in prognosis than the steady one（P〈0.01）. Conclusion The fluctuation of plasma D-dimmer level in patients with cerebral infarction has, to some extent, instructive significance in the prognosis judgement.