检测脑卒中患者纤维蛋白原及血小板参数变化的临床意义

Clinical significance of the changes of fibrinogen and indexes of platelet in patients with cerebral apoplexy

目的探讨脑卒中患者纤维蛋白原(Fib)、血小板总数(PLT)、血小板平均体积(MPV)和血小板体积分布宽度(PDW)的临床意义。方法选取脑梗死患者65例(大面积脑梗死39例,腔隙性脑梗死26例)、脑出血患者50例和健康者50例,患者在发病后72h内抽取静脉血抗凝,所有研究对象均未接受任何止血凝血药物,检测其PLT、MPV、PDW及Fib水平。分析脑梗死患者和健康者、脑出血患者和健康者、脑梗死患者和脑出血患者、大面积脑梗死患者与腔隙性脑梗死患者在Fib及血小板参数四项指标上差异有无统计学意义。结果脑梗死组与健康对照组比较MPV、PDW、Fib明显升高(P<0.05),PLT明显降低(P<0.05);脑出血组与健康对照组比较MPV、PDW、Fib明显升高(P<0.05),PLT明显降低(P<0.05);脑梗死组与脑出血组比较PLT、MPV、Fib、PDW四项指标差异无统计学意义(P>0.05);大面积脑梗死组与腔隙性脑梗死组比较PLT、MPV、Fib、PDW四项指标差异无统计学意义(P>0.05)。结论血小板体积增大、血浆纤维蛋白原水平增高是发生脑卒中的重要危险因素之一;观察四项指标变化对病情诊断和病情判断具有重要的指导意义。

Objective To explore the clinical significance of peripheral levels of platelet count （PLT）, mean platelet volume （MPV）and plasma levels of fibrinogen （Fib）, platelet volume distribution width（PDW）in patients with cerebral apoplexy. Methods The peripheral levels of PLT and MPV and plasma levels of Fib and PDW were measured in 65 patients with cerebral infarction, 50 patients with cerebral hemorrhage and 50 healthy controls. Results The PLT level in cerebral infarction and cerebral hemor rhage patients was significantly lower than healthy controls（P〈0.05）, but the MPV, PDW and Fib levels were significant increased （P〈0.05） ,while there were no significant differences between cerebral infarction and cerebral hemorrhage patients,and between cerebral infarction patients with different area of infarction（P〉0.05）. Conclusion Increase of the volume of platelet and the plasma level of Fib might be important risk factors of cerebral apoplexy and the measurement of the four indexes of platelet could have certain clinical significance for the diagnosis and the judgment of pathogenetic condition for cerebral apoplexy.