冠心病患者凝血功能与脑血管意外关系的临床观察

Correlation between coagulation function and cerebral vascular accident of patients with coronary heart disease

目的研究冠心病患者的凝血功能与脑血管意外关系。方法选取商丘市第一人民医院自2013年6月至2014年6月收治的冠心病患者100例,将其作为临床研究对象,出院后对患者进行为期8个月的随访调查,统计患者脑血管意外的发生率以及死亡率。1组:死于脑血管意外的患者;2组:致死性脑血管意外的患者;3组:未发生脑血管意外的患者。对3组患者的凝血功能指标进行比较。结果本组研究的100例患者中有23例患者死于脑血管意外;31例患者发生脑血管意外但未死亡;46例患者未发生脑血管意外。3组患者凝血功能指标比较,1组患者的凝血功能指标血浆纤维蛋白原(6.1±1.3)g/L明显高于2组(4.5±1.2)g/L和3组(2.14±1.08)g/L;D-二聚体:1组(1.5±0.7)g/L,2组(0.7±0.2)g/L,3组(0.2±0.1)g/L,活化部分凝血酶时间:1组(43±5.7)s,2组(32±4.8)s,3组(27.9±4.6)s;血浆凝血酶原时间:1组(17.6±2.8)s,2组(13.1±2.1)s,3组(11.6±1.3)s,1组患者的凝血功能指标明显高于2组和3组,差异有统计学意义(P<0.05)。结论冠心病患者的凝血功能与脑血管意外的发生有直接的关系,因此临床上通过控制患者的凝血功能指标能够有效的降低死亡率。

Objective To study the relationship between coagulation function and cerebral vascular accident in patients with coronary heart disease. Methods Selected 100 patients with coronary heart disease in our hospital from June 2013 to July 2014 as clinical research object. The patients were followed up for 8 months after discharge to gather the occurrence and mortality rate of cerebrovascular accident according to three group divided. Group 1:the patients died of cerebrovascular accident; group 2:the patients with nonfatal cerebrovascular accident; group 3:the patients with no cerebrovascular accident. The coagulant function indexes of three groups of patients were compared. Results Among 100 patients participated in this study, 23 patients died of cerebrovascular accident, mortality rate were 23%; 31 cases of patients with cerebrovascular accident but not died, accounting for 31%. The rest of the 46 patients had no cerebrovascular accident, accounting for 46%. The plasma fibrinogen of group1[(6. 12±1. 32) g/L] were significantly greater than those of group 2[(4. 52±1. 22) g/L] and group 3[(2.14±1. 08) g/L]. The D-dimer of group 1, 2, 3 were (1. 48±0. 67), (0. 68±0. 21), (0. 23±0.11) g/L respectively. The activated partial thromboplastin time of group 1, 2, 3 were (43±6), (32±5), (28±5) s respectively. The plasma prothrombin time of group 1, 2, 3 were (17.6±2.8), (13.1±2.1), (11.6±1.3)s respectively. lation function index of group 1 were significantly higher than those in group 2 and group 3 (P<0. 05). Conclusion The blood coagulation function of patients with coronary heart disease have direct relationship with the occurrence of cerebrovascular accident, therefore by controlling the blood coagulation function of patients can lower the mortality rate effectively.