急性缺血性脑卒中TOAST病因分型对血浆纤维蛋白原的影响

The Correlation of Plasma Fibrinogen to Acute Cerebral Ischemic Stroke TOAST Style

目的探讨急性脑卒中TOAST病因分型对血浆纤维蛋白原(Fib)的影响。方法 2009年8月—2011年12月在神经内科住院登记的符合入选标准的223例急性缺血性卒中患者,依TOAST标准进行分型,分为5组(亚型),分别为大动脉粥样硬化性卒中组(LAA组)、心源性脑栓塞组(CE)、小动脉闭塞性卒中组(SVA组)、其他原因卒中组(SOE组)和不明原因卒中组(SUE组)。检测各亚型的Fib水平,并分析LAA组Fib水平与神经功能缺损程度以及临床疗效的相关性。结果本研究急性缺血性卒中的构成中,最多为LAA组(42.2%),其次分别为SVA组(23.3%),CE组(18.8%)和SUE组(14.3%)。与对照组(正常健康体检者)相比,急性缺血性卒中组Fib水平升高有统计学意义。各亚型中,LAA组的Fib水平最高,与其他亚型组相比差异有统计学意义。以LAA组为研究对象,Fib水平与神经功能缺损程度有关。结论血浆Fib的水平与脑卒中患者的神经功能缺损程度和临床疗效密切相关,临床上检测血浆Fib的水平,可以为急性脑卒中各亚型的治疗提供一定的理论指导。

Objective To investigate the effect of plasma fibrinogen and subtypes of acute cerebral ischemic stroke TOAST style.Methods 223 subjects met the selection criteria were assigned to this study from the registered inpatient with acute ischemic stroke in neurology from Aug 2009 to Dec 2011.They were classified into 5 subtypes shown as follows,large-artery atherosclerosis group（LAA group）,cardio embolism group（CE group）,small-vessel occlusion group（SVA group）,Small-vessel occlusion group（SOE group）,and stroke of undetermined etiology group（SUE group）.Plasma Fib levels in different subtypes were tested and the correlation among Fib level,degree of neurological deficits and clinical efficacy in LAA group were analyzed.Results Among the composition of acute ischemic stroke in this study,LAA was major（42.2%）,followed by the SVA（23.3%）,CE（18.8%） and the SUE（14.3%）.When compared to the control group（healthy people）,plasma Fib level in acute ischemic stroke group was statistically increased.Among other types,plasma Fib level in LAA was highest,with statistical difference observed.For LAA,a correlation was observed between plasma Fib level and neurological deficits.Conclusion Plasma Fib level is closely related to neurological deficits in patients with stroke and clinical efficacy,therefore,detection of plasma Fib levels can provide theoretical guidance for the treatment of various subtypes of acute ischemic stroke in clinical practice.