急性缺血性中风患者凝血及心电图指标与预后的相关性研究

A Study on the Correlation Between Coagulation,Electrocardiograph Index of Acute Ischemic Stroke Patients and Prognosis

目的探讨急性缺血性中风(AIS)患者凝血指标及心电图异常与预后的关系。方法选取2013年5月至2015年5月医院收治的急性IS患者85例作为急性缺血性中风组,1例脱落,最终纳入84例,经治疗出院3个后随访改良Rankin量表(mRS),以mRS≤2分作为预后良好组63例,以mRS>2分作为预后不良组21例,同期选取健康志愿者50例作为对照组,检测血小板聚集率(PAg T)、血小板计数(PLT)、血小板膜P-选择素(CD62p)、血栓素(TXA2)、纤维蛋白原(Fbg)、D二聚体(D-D),记录入院48 h内异常心电图发生率。结果 AIS组PAg T、PLT、CD62P、TXA2、Fbg、D-D显著高于对照组(P<0.05),AIS预后良好组显著低于预后不良组(P<0.05)。AIS组S-T段改变、T波改变发生率分别为13.10%、6.67%显著高于对照组2.0%、2.0%(P<0.05)。AIS预后两组S-T段改变发生率7.94%显著低于对照组28.57%(P<0.05)。结论 AIS患者血小板活血化、纤溶亢进及心电图S-T段改变对疾病预后有负面影响。

Objective To explore the correlation between coagulation index of acute ischemic stroke（ AIS） patients,abnormal ECG and prognosis. Methods 85 cases of acute IS patients treated in our hospital from May 2013 to May 2015 were selected as AIS group,1 cases fell off,and finally 84 cases were included,all patients were followed up 3 months after the operation and modified Rankin Scale（ mRS） were used,mRS ≤ 2scores were treated as good prognosis group（ 63 cases）,mRS 2 scores were treated as bad prognosis group（ 21 cases）,50 healthy volunteers were selected as the control group in the same period,platelet aggregation rate（ PAg T）,platelet count（ PLT）,platelet membrane P- selectin（ CD62p） and thromboxane（ TXA2）,fibrinogen（ Fbg）,D-dimer（ D-D） were detected,the incidence rate of abnormal ECG was recorded in 48 h after admission. Results PAg T,PLT,CD62 p,TXA2,Fbg and D-D in AIS group were significantly higher than the control group（ P〈0. 05）,AIS good prognosis group were significantly lower than poor prognosis group（ P〈0. 05）. The occurrence rate of S-T segment change and T wave change in acute IS group were 13. 10%,6. 67% respectively,which were significant higher than the control group 2. 0%,2. 0%（ P〈0. 05）. The incidence of S-T segment changes in two groups of patients with acute IS prognosis 7. 94% were significantly lower than the control group 28. 57%（ P〈0. 05）. Conclusion Platelet promoting blood,hyperfibrinolysis and S-T segment changes of ECG of acute IS patients have a negative impact on prognosis of disease.