急性心肌梗死患者血液流变学、纤维蛋白原及D-二聚体的变化及其临床意义

Clinical analysis of hemorheology, fibrinogen, D-dimer change in acute myocardial infarction.

目的观察急性心肌梗死(AMI)患者血液流变学、纤维蛋白原及D-二聚体的变化,探讨其临床价值。方法选择我院收治的AMI患者44例作为AMI组,陈旧性心肌梗死(OMI)患者32作为OMI组,并选取同期门诊体检的健康人30例作为NC组。应用全自动血黏度测试仪测定受试对象血液流变学指标、纤维蛋白原(Fig)和D-二聚体水平,并对结果进行比较分析。结果①AMI组纤维蛋白原、D-二聚体水平较OMI组和NC组明显升高,差异有统计学意义(P<0.05),OMI组与NC组纤维蛋白原、D-二聚体水平比较差异无统计学意义(P>0.05);②AMI组与OMI组和NC组比较,血液流变学检查全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、红细胞压积、红细胞聚集指数、血沉均有不同程度的增高,差异有统计学意义(P<0.05),OMI组与NC组血液流变学指标比较差异无统计学意义(P>0.05)。结论急性心肌梗死患者血浆纤维蛋白原、D-二聚体水平明显升高,血液流变学指标发生明显改变,血液流变学及凝血机制异常在急性心肌梗死的发生和发展中起到重要作用,对于急性心肌梗死的诊断、疗效观察和预后判断有一定的临床价值。

Objective To observe hemorheology, fibrinogen, D-dimer change in acute myocardial infarction, and discuss its clinical value. Methods 44 patients with acute myocardial infarction （AMI） were selected as AMI group, 32 patients with old myocardial infarction （OMI） as the OMI group, and 30 cases of healthy people during the same period as the NC group. Hemorheology, fibrinogen （FIG）, and the D-dimer levels were tested. Results FIG and D-dimer levels in AMI group were significantly increased compared with those in the OMI group or NC group （P0.05）, but no difference of FIG and D-dimerbetween OMI group and NC group. Hemorheology check blood viscosity, low cut, cut in whole blood viscosity, high shear whole blood viscosity, plasma viscosity, hematocrit, erythrocyte aggregation index, erythrocyte sedimentation rate in AMI group were increased compared with those of the OMI group orNC group （P0.05）, but no difference of hemorheology between OMI group and NC group. Conclusion The higher plasma fibrinogen and the D-dimer levels,the hemorheology apparent change play an important role in the diagnosis, curative effect and prognosis of acute myocardial infarction.