进展性脑梗死患者血清C反应蛋白和D-二聚体的动态改变

Dynamic Changes of Serum C-reactive Protein and D-dimer in Patients with Progressive Cerebral Infarction

目的探讨动态观察血C反应蛋白(CRP)、纤维蛋白原(FIB)和D-二聚体的变化对进展性脑梗死的早期识别和及时处理的意义。方法选择73例颈内动脉系统进展性脑梗死患者为进展组,184例非进展性脑梗死患者为非进展组,分别检测患者入院次日(第1天)、第3天、第7天和第14天血CRP、FIB和D-二聚体含量动态改变,颈部血管超声检查及神经功能缺损评分(NIHSS)。结果进展组患者入院时颈动脉狭窄的比例高于非进展组(43.8%vs 30.9%,P<0.01);非进展组CRP在第3天、第7天和第14天下降,进展组CRP在第3天明显增加、随后在第7天和第14天下降,但明显高于非进展组(P<0.01)。FIB和D-二聚体的含量在进展组明显增加,高于非进展组(P<0.01或P<0.05)。进展组患者NIHSS评分在入院后进行性增高,而非进展组患者NIHSS评分呈下降趋势,两组比较差异有统计学意义(P<0.01)。结论动态观察FIB和D-二聚体的变化可能有助于进展性脑梗死的早期识别和及时处理。

Objective To explore the dynamic changes and the clinical meanings of blood C-reactive protein,fibrinogen and D-dimer in early identification and the timely copy of processing cerebral infarction.Methods Blood C-reactive protein,fibrinogen and D-dimer levels in 73 cases of progressive cerebral infarction patients from the internal carotid artery system（progressive group） and 184 cases of patients with non-progressive cerebral infarction（non-progressive group） were measured by automatic biochemical analyzer at next day（day 1）,day 3,day 7 and day 14 after being admitted to hospital.Carotid vascular ultrasound and neurological deficit score（NIHSS） were also recorded.Results Carotid stenosis ratio in progressive group was significantly higher than that in non-progressive group（43.8% vs 30.9%,P0.01） on admission.In non-progressive group,C-reactive protein decreased on the day 3,day 7,and day 14.In progressive group,C-reactive protein increased significantly on the day 3,followed by decline on the day 7 and day 14,but significantly higher than those in non-progressive group（P0.01）.Fibrinogen and D-dimer levels increased significantly in the progressive group than those in non-progressive group（P0.01 or P0.05）.Progressive group patients NIHSS score progressively increased after admission,while non-progressive group patients NIHSS score presented downward trend,the difference between the two groups was significant（P0.01）.Conclusion The dynamic observation on the changes of fibrinogen and D-dimer may contribute to early identification and timely treatment of progressing ischemic stroke.