脑梗死与脑出血患者凝血功能指标和D-二聚体变化的分析

Clinical analysis of changes of blood coagulation index and plasma D dimmer in patients with cerebral infarction and cerebral hemorrhage

目的通过对脑梗死与脑出血患者凝血功能指标和D-二聚体的检测,探讨凝血功能指标和D-二聚体变化机制,为其鉴别诊断寻求客观的临床实验室指标。方法采用法国Diagnostica Stago公司生产的STA-R全自动血凝仪对2011年9月至2012年4月我院38例脑梗死与40例脑出血患者标本凝血功能指标和D-二聚体进行检测分析。结果脑梗死组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均低于健康对照组,差异有统计学意义(P<0.01);纤维蛋白原(Fib)、D-二聚体含量均高于健康对照组,差异有统计学意义(P<0.01)。脑出血组PT、APTT、TT均高于健康对照组,差异有统计学意义(P<0.01或P<0.05);Fib的含量低于健康对照组,差异有统计学意义(P<0.01);D-二聚体含量高于健康对照组,差异有统计学意义(P<0.01)。结论脑梗死与脑出血患者发病后凝血功能指标和D-二聚体均存在变化,可以根据其各项指标的变化进行初步鉴别诊断,为临床诊治脑血管疾病提供客观实验室诊断依据。

Objective To investigate the mechanism of blood coagulation index and plasma D dimmer, and to find out objective clinical laboratory indices of identifying and diagnosing for patients with cerebral infarction and cerebral hemorrhage by detecting the blood coagulation index and plasma D dimmer in patients with cerebral infarction and cerebral hemorrhage. Methods Thirty-eight patients with cerebral infarction and 40 patients with cerebral hemorrhage were detected from September 2011 to April 2012 with STA-R and the blood coagulation index and plasma D dimmer were collected and analyzed. ~Results According to the investigation and analysis from group with cerebral infarction and normal human group, prothrombin time （PT）, activated partial thromboplasting time （APTF）, thrombin time （TY） were obviously dropped than normal human （P〈0.01）; Fibrinogen （Fib）, D dimmer （DD） were obviously higher than normal human group （P〈0.01）. PT, APTT, TT from group with cerebral hemorrhage were obviously higher than the one from normal group （P〈0.01 or P〈0.05）; Fib were obviously dropped than the one from normal human （P〈0.01） and DD were obviously higher than normal human group （P〈0.01）. Conclusion There are obvious changes of blood coagulation index and plasma D dimmer in patients with cerebral infarction and cerebral hemorrhage and the patients can be detected and diagnosed initially according to changes of blood coagulation index and plasma D dimmer. And this can provide a basis of objective laboratory diagnosis for clinical diagnosis and treatment of eerebrovascuiar disease.