脑梗死患者的D-二聚体与梗死亚型及其预后的关系

D-Dimer in ischemic cerebral infarction: association with infarction sub-type, short and long term outcomes.

目的 探讨脑梗死亚急性期患者的 D-二聚体水平与梗死类型的关系及其近、远期预后价值。方法 对 172例脑梗死患者的血浆 D-二聚体进行了测定。对患者出院时的临床神经功能缺损程度进行评定 ,并观察其出院后再发心血管终点事件及死亡。结果 心源性脑梗死患者的 D-二聚体水平最高、血栓形成性脑梗死患者的 D-二聚体居中、腔隙性脑梗死患者的 D-二聚体水平最低 ,与健康人无显著差异。 D-二聚体水平与出院前的临床神经功能缺损评分直线相关。随访 1.4 5年发现 ,D-二聚体是心血管事件的独立危险因子。D-二聚体水平高于 1.5 1m g/ L 出现心脑血管事件的相对危险度为 1.73,校正后为 1.4 1。结论 D-二聚体与脑梗死的类型有关 。

Objective To investigate the association between plasma D-Dimer with infarction sub-type, short- and long-term predictive value of cardiovascular outcomes in patients with sub-acute cerebral infarction. Methods Plasma D-Dimer was measured in patients with cerebral infarction. The outcomes were evaluated before discharge and in the follow-up. Results The level of plasma D-Dimer was significantlythe highest in the patients with cardioembolic infarction, in the medium with atherothrombotic infarction, the lowest with lacunar infarction, there was nosignificant difference between the patients with lacunar infarction and healthy controls. There was a linear relationship between plasma D-Dimer and neurological function defect score. In a multivariate model, D-Dimer was found to be an independent risk factor associated to total recurrent cardiovascular events over an average of 1.45 years follow-up. The relative risk of D-Dimer more than 1.51 mg/L for the total cardiovascular events was 1.73, and 1.41 after adjustment. Conclusions The plasma D-Dimer in the sub-acute phase is associated with sub-type of cerebral infarction,and is an independent risk factor of recurrent cardiovascular events.