纤维蛋白原与不同类型脑梗死发病及短期预后间的相关性

Correlation of Fibrinogen Level with Short-term Prognosis of Different Subtypes of Cerebral Infarction

目的:探讨血浆纤维蛋白原(Fib)水平与不同类型脑梗死发病及短期预后的关系。方法:选取239例急性期脑梗死患者为病例组,根据TOAST分型分为心源性脑栓塞(CE)亚组、大动脉粥样硬化性卒中(LAA)亚组、小动脉闭塞性卒中(SAO)亚组、其他原因引发的缺血性卒中(SDE)亚组及原因不明的缺血性卒中(SUE)亚组等5个亚组,并招募127例健康志愿者为对照组。应用Clauss法测定受试者血浆Fib水平,并对各组患者在入院后24 h及第10天分别进行神经功能评定。结果:CE亚组及LAA亚组血浆Fib水平[(4.30±1.08)g/L,(4.29±1.26)g/L]均明显高于对照组[(3.33±0.52)g/L]及SAO亚组[(3.42±0.68)g/L](P<0.05);SAO亚组血浆Fib水平与对照组比较无统计学差异。多元Logistic回归显示,血浆Fib水平与CE及LAA亚组的发病均呈显著相关,但与SAO亚组的发病无明显相关性;脑梗死急性期血浆Fib水平与CE及LAA亚组患者的短期预后有明显的相关性,与SAO亚组患者的短期预后无明显相关关系。结论:血浆Fib水平可能是CE及LAA发病及短期预后不良的独立危险因素,但可能与SAO的发病及短期预后无明显相关。

Objective： To evaluate the correlation between plasma fibrinogen level and the incidence and Short-term outcome of cerebral infarction （CI） with various subtypes. Methods： Two hundred and thirty-nine acute CI patients and 127 healthy volunteers as control were recruited for the study. The patients were then divided into CE group, LAA group, SAO group, SDE group and SUE group by TOAST. The Plasma fibrinogen levels were determined by the Ctauss method. The neurological function of patients in each group had been evaluated at days 1 and 10 since hospitalization respectively. Results： The fibrinogen level in patients with CE [（4. 30± 1.08）g/L] and LAA[（4.29±1.26）g/L] were significantly higher than those in controls [（3.33 ±0.52）g/L] （P〈0.05）, as well as patients with SAO [（3.42±0.68）g/L] （P〈0. 05） ,while there was no difference in plasma fibrinogen between patients with SAO and controls. Multiple logistic regression model showed that there was significant correlation between plasma fibrinogen levels and the incidence of patients with CE and LAA, but not patients with SAO. Multiple logistic regression analysis indicated significant correlations between plasma fihrinogen levels in acute phase of CI and short-time prognosis of patients with CE and LAA, but not patients with SAO.Conclusion： Plasma fibrinogen level might be an independent risk factor of pathogenesis and poor short-term prognosis of patients with CE and LAA, but not in patients with SAO.