脑卒中患者血小板参数和纤维蛋白原水平变化的临床价值

Clinical value of platelet parameters and fibrinogen level changes in stroke patients

目的:探讨血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)和纤维蛋白原(Fg)水平对脑卒中诊断和病情预测的价值。方法:选择98例脑卒中患者,根据病理类型分为脑梗死组(43例,包括23例大面积脑梗死患者和20例腔隙性脑梗死患者)和脑出血组(45例)。另选51例同期行健康体检者为健康对照组。检测并对比三组PLT、MPV、PDW和Fg水平。结果:与健康对照组比较,脑梗死组和脑出血组的PLT[(217.86±53.92)×10~9/L比(180.40±32.81)×10~9/L比(174.09±40.18)×10~9/L]显著降低,MPV[(8.03±0.99)×10^(-15) L比(9.59±1.04)×10^(-15) L比(8.91±1.43)×10^(-15) L]、PDW [(13.97±1.22)%比(16.43±1.07)%比(16.09±0.97)%]和Fg[(3.17±0.95)g/L比(5.01±1.33)g/L比(4.91±0.92)g/L]水平显著升高(P均=0.001);与脑梗死组比较,脑出血组MPV明显降低(P=0.012)。大面积脑梗死组、腔隙性脑梗死组的血小板参数和Fg水平均无显著差异(P均>0.05)。结论:检测血小板计数、血小板平均体积、血小板分布宽度和纤维蛋白原水平对脑卒中的诊断和病情预测中具有较好的应用价值,值得推广。

Objective:To explore diagnostic and predictive value of platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW)and fibrinogen(Fg)level for stroke.Methods:According to pathological pattern,a total of98stroke patients were divided into cerebral infarction group(n=43,including23cases with large size cerebral infarction and20cases with lacunar infarction)and cerebral hemorrhage group(n=45).Another51healthy subjects undergoing physical examination simultaneously were enrolled as healthy control group.PLT,MPV,PDW and Fg level were measured and compared among three groups.Results:Compared with healthy control group,there were significant reduction in PLT[(217.86±53.92)×109/L vs.(180.40±32.81)×109/L vs.(174.09±40.18)×109/L]and significant rise in MPV[(8.03±0.99)×10-15L vs.(9.59±1.04)×10-15L vs.(8.91±1.43)×10-15L],PDW[(13.97±1.22)%vs.(16.43±1.07)%vs.(16.09±0.97)%]and Fg level[(3.17±0.95)g/L vs.(5.01±1.33)g/L vs.(4.91±0.92)g/L]in cerebral infarction group and cerebral hemorrhage group,P=0.001all;Compared with cerebral infarction group,there was significant reduction in MPV in cerebral hemorrhage group,P=0.012.There were no significant difference in platelet parameters and Fg level between large size cerebral infarction group and lacunar infarction group,P>0.05all.Conclusion:Detection of PLT,MPV,PDW and Fg level possess good application value in diagnosis and prediction of stroke,which is worth extending.