脑梗死急性期血浆纤维蛋白原水平与预后的关系

Correlation between plasma fibrinogen content and prognosis in patients with acute cerebral infarction

目的研究脑梗死急性期血浆纤维蛋白原(fibrinogen,FIB)水平与患者预后的关系。方法 106名非心源性栓塞性脑梗死患者,发病后72 h内采集肘静脉血测定血浆FIB浓度,应用美国国立卫生院卒中量表(NIHSS)评价神经功能缺损,Glasgow昏迷量表(GCS)评价意识水平,Barthel指数(BI)评估发病后3月的生活能力。结果 106例急性脑梗死患者入院时FIB为2.36-6.42 g/L(3.58±0.76 g/L),其中FIB增高(>4 g/L)68例(64.2%)。单因素及多因素分析显示,影响入院时FIB水平的因素包括:年龄(OR=1.026,P=0.011)、入院时GCS评分(OR=1.546,P=0.006)、入院时NIHSS评分(OR=1.358,P=0.042)和梗死大小(OR=1.256,P=0.024)。与脑梗死发病3月BI相关的因素包括:入院时NIHSS评分(OR=5.110,P=0.001)、年龄(OR=3.598,P=0.006)、梗死大小(OR=2.286,P=0.026)、空腹血糖(OR=1.024,P=0.021),急性期血浆FIB水平与脑梗死3月残疾程度有相关性(OR=2.683,P=0.019)。结论血浆FIB增高是急性期非心源性脑梗死的常见表现,且FIB水平与脑梗死病情严重程度密切相关,急性期FIB水平与脑梗死3月残疾程度也有相关性。

Objective To explore the correlation between plasma fibrinogen content and prognosis in patients with acute cerebral infarction. Methods A total of 106 patients with non-cardiogenic cerebral infarction were enrolled.Fibrinogen in plasma from elbow vein was measured in 72 h after the disease attack.Neurological impairment was assessed using the national institutes of health stroke scale（NIHSS）,the level of consciousness was evaluated by Glasgow coma scale（GCS）,and the disability of living was estimated by Barthel index（BI） at 3 month after the disease attack.Results Plasma fibrinogen of 106 patients was 2.36-6.42 g/L[（3.58±0.76 ） g / L],with an increase in 6 8 cases（64.2%）.The single and multiple factor analysis showed that age（OR = 1.0 2 6,P = 0.011）,GCS（OR = 1.546,P = 0.006）,NIHSS（OR = 1.358,P=0.042） and infarct size（OR = 1.256,P =0.024） were related to plasmatic fibrinogen content.The risk factors related to disability in living at 3 month after the disease attack included age（OR = 3.598,P =0.006）,NIHSS（OR =5.110,P =0.001）.infarct size（OR =2.286,P = 0.026） and fasting blood glucose（OR = 1.024, P = 0.021）,while plasmatic fibrinogen content was excluded（OR =2.783,P = 0.259）.Conclusion Increased plasma fibrinogen is a common performance in non-cardiogenic cerebral infarction.Plasma fibrinogen content is closely related to the severity of cerebral infarction and disability at 3 month after the disease attack.