脑梗死患者血小板参数凝血功能和血液流变学指标检测的临床价值

Clinical value of indexes of platelet parameters,blood coagulation function and blood rheology in patients with cerebral infarction

目的探讨脑梗死患者血小板参数、凝血功能和血液流变学指标检测的临床价值。方法按照神经功能缺损评分[入院卒中量表(NIHSS)评分]将87例脑梗死患者分为轻度缺损组、中度缺损组和重度缺损,另选取我院同期健康志愿者50名。测定所有研究血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)及血小板分布宽度(PDW),凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)及D-二聚体(D-D),全血黏度、血浆黏度及红细胞比容。结果随着脑梗死神经功能缺损程度的加重,患者PLT持续降低,MPV、PDW、Fib及D-D持续升高,组间比较差异有统计学意义(P<0.05);PCT、PT、APTT及TT在健康对照组及脑梗死组比较差异无统计学意义(P>0.05)。随着脑梗死神经功能缺损程度的加重,患者全血黏度、血浆黏度及红细胞比容均持续上升,且组间比较差异有统计学意义(P<0.05)。结论血小板参数、凝血功能及血液流变学指标的检测有助于脑梗死患者的病情预测和早期诊断,具有较高的应用价值。

Objective To explore the clinical value of platelet parameters,blood coagulation function and blood rheology in patients with cerebral infarction.Methods According to the neural function defect score（admission Stroke Scale score of NIHSS）,eighty-seven patients with cerebral infarction were divided into mild defect group,moderate defect group and severe defect group and another 50 healthy volunteers were chosen as the control group for the study.The platelet count（PLT）,mean platelet volume（MPV）,platelet hematocrit（PCT）and platelet distribution width（PDW）,prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（Fib）and D-dimer（D-D）,whole blood viscosity,plasma viscosity and hematocrit of all the patients were determined and compared.Results With the increasing degree of nerve function in cerebral infarction patients,the PLT was decreased,while the MPV,PDW,Fib and D-D were continuing to rise,there was statistically significant difference between the two groups（P〈0.05）.While there was no significant difference of the PCT,PT,APTT and TT in the healthy control group and cerebral infarction group（P〈0.05）.With the increasing degree of cerebral infarction,the whole blood viscosity,plasma viscosity and hematocrit were rising,and there was significant difference between the two groups（P〈0.05）.Conclusion The detection of platelet parameters,blood coagulation function and hemorheology is helpful for the prediction and early diagnosis in cerebral infarction patients.