急性脑梗死患者血清中Lp(a)、CRP、D-二聚体及纤维蛋白原水平变化的临床意义

Clinical significance of changes of serum Lp(a), C-reactive protein, D-dimer and fibrinogen expression in patients with acute cerebral infarction

目的探讨急性脑梗死患者血清脂蛋白a [Lp(a)]、C反应蛋白(CRP)、D-二聚体、纤维蛋白原表达变化的临床意义。方法将我院急诊收治的200例急性脑卒中患者和同期来我院接受健康体检的120例健康体检者分别设为急性脑梗死组和健康对照组,检测健康对照组和急性脑梗死组治疗前、后的血清Lp(a)、CRP、D-二聚体、纤维蛋白原水平。再将急性脑梗死组患者根据神经功能缺损程度的不同分为轻型组、中型组和重型组三个亚组,对比三个亚组治疗前、后的血清Lp(a)、CRP、D-二聚体、纤维蛋白原水平。结果急性脑梗死组治疗前的血清Lp(a)、CRP、D-二聚体、纤维蛋白原表达水平均显著高于健康对照组(P<0.01),治疗后上述指标表达水平均明显高于健康对照组(P <0.05)。治疗前、后,急性脑梗死组中重型组患者的血清Lp(a)、CRP、D-二聚体、纤维蛋白原水平显高于中型组、轻型组(P <0.05),轻型组患者上述指标表达水平最低。结论血清Lp(a)、CRP、D-二聚体、纤维蛋白原水平变化能够反映急性脑梗死患者病情严重程度,可作为评价该疾病患者临床治疗效果及预后的辅助指标。

Objective To investigate the clinical significance of changes of serum lipaprotein a[Lp（a）], C-reeactive protein（CRP）, D-dimer and fibrinogen expression in patients with acute cerebral infarction. Methods 200 eases of acute stroke patients in emergency department and 120 patients who received physical examination in our hospital during the same period were selected as acute cerebral infaretion group and healthy control group respectively. Before and after treatment, theserum levels of Lp（a）, CRP, D-dimer and fibrinogen of healthy control group andacute cerebral infarction groupwere measured. According to the degree of neurologieal deficit, the patients with acute cerebral infarction were divided into three subgroups： mild group, medium group and severe group.The serum levels of Lp （a）, CRP, D- two mer and fibrinogen were compared between the three subgroups before and after treatment. Results The serum levels of Lp（a）, CRP, D-dimer and fibrinogen in acute cerebral infarction group were significantly higher than those in healthy control group before treatment（P 〈 0.01）, and theserum levels of the above-mentioned indicators in acute cerebral infarction group were significantly higher than those in the healthy control group after treatment （P 〈 0.05）.Before and after treatment, the serum levels of Lp （a）, CtlP, D-dimer and fibrinogen in severe group were significantly higher than those in mediumgroup and light group （P 〈 0.05）, while those in the light group were the lowest. Conclusion The changes of serum Lp（a）, CRP, D-dimer and fibrinogen levels can reflect the severity of acute cerebral infarction. They can be used as auxiliary indicators to evaluate the clinical therapeutic effect and prognosis of patients with acute cerebral infarction.