静脉血液中D-二聚体、同型半胱氨酸、纤维蛋白原、红细胞沉降率与不同类型急性脑梗死的关系

Correlation between plasma markers DD,Hcy,Fib,ESR and different types of acute cerebral infarction

目的静脉血液中D-二聚体(DD)、同型半胱氨酸(Hcy)、纤维蛋白原(Fib)、红细胞沉降率(ESR)与不同类型急性脑梗死的关系。方法以2014年1月至2015年10月接受治疗的发生急性多发脑梗死患者500例为研究对象,按照TOAST分型标准分为大动脉粥样硬化型(LAA)组134例、小动脉闭塞型(SAO)组160例、心源性脑栓塞型(CE)组80例、其他明确病因型(SOE)组45例、不明病因型(SUE)组81例。另选同期健康体检者100例为对照组。检测所有受试者静脉血液中DD、Hcy、Fib、ESR水平,并分析它们与不同类型急性脑梗死的关系。结果 CE组DD水平和LAA组Hcy水平均明显高于其他各组,LAA组和CE组的Fib水平和ESR水平均明显高于其他各组,SAO组、SOE组和SUE组ESR水平均明显高于对照组(P均<0.05)。血浆标志物DD水平与CE相关(r=0.147,P=0.046),Hcy水平与LAA相关(r=0.185,P=0.004),Fib水平与LAA、CE均存在密切相关(r=0.228,P<0.01;r=0.113,P=0.048),ESR水平与LAA、SAO、CE、SOE及SUE均相关(r=2.031,P<0.01;r=0.131,P=0.039;r=3.212,P<0.01;r=0.213,P=0.041;r=0.452,P=0.027)。结论不同类型的急性脑梗死,静脉血液中DD、Hcy、Fib、ESR水平存在明显的差异,可作为急性脑梗死病因的判断和评估患者预后的指标。

Objective To study the relationship of plasma markers D- Dimer（ DD）,homocysteine（ Hcy）,fibrinogen（ Fib）,erythrocyte sedimentation rate（ ESR） in different types of acute cerebral infarction（ ACI）. Methods Five hundred ACI patients were divided into large artery atherosclerotic stroke（ LAA） group（ 134 patients）,small artery occlusive strike（ SAO） group（ 160 patients）,cardiogenic cerebral embolism（ CE） group（ 80 patients）,stroke of other demonstrated etiology（ SOE） groups（ 45 patients） and unexplained ischemic stroke（ SUE） group（ 81 patients） according to TOAST classification criteria from January 2014 to October 2015. Another 100 healthy examinee were enrolled as control group. Plasma marker levels were detected in all subjects,and their relationship with different types of acute cerebral infarction were analyzed.Results The level of DD in CE group and level of Hcy in LAA group were significantly higher than those in the other groups. The level of FIB and ESR in LAA and CE groups were significantly higher than those in the other groups. ESR levels in SAO,SOE and SUE group were significantly higher than control group（ P 〈0. 05）. There were remarkable correlation between DD and CE（ r = 0. 147,P = 0. 046）,Hcy and LAA（ r =0. 185,P = 0. 004）,Fib and LAA,CE（ r = 0. 228,P 〈0. 01; r = 0. 113,P = 0. 048） ESR and LAA,SAO,CE,SOE and SUE（ r = 2. 031,P 〈0. 01; r = 0. 131,P = 0. 039; r = 3. 212,P 〈0. 01; r = 0. 213,P = 0. 041; r = 0. 452,P = 0. 027）. Conclusion Levels of plasma marker showed obvious differences in different types of acute cerebral infarction,it could be used as the index to diagnosis cause of acute cerebral infarction and assess the prognosis of patients.