摘要
目的探讨急性脑梗死患者血清纤维蛋白原、D-二聚体与颈动脉粥样硬化斑块的关系。方法选择解放军第三医院神经内科白2009年4月至2011年4月收治的120例急性脑梗死患者f脑梗死组）、同期单纯颈动脉粥样硬化而无脑梗死患者60例（颈动脉粥样硬化组）和健康体检者80例（正常对照组1作为研究对象，采用双抗体夹心法测定血清D-二聚体含量，全自动血凝仪测定纤维蛋白原含量，颈动脉彩色多普勒超声检测患者颈动脉粥样硬化斑块和颈动脉内一中膜厚度（nVIT）值。结果脑梗死组、颈动脉粥样硬化组及正常对照组血清纤维蛋白原、D-二聚体水平及颈动脉IMT值依次降低，差异有统计学意义（P〈0．05）；进展性卒中患者血清纤维蛋白原、D-二聚体水平高于非进展性卒中患者，差异有统计学意义（P＜0．05）；随着动脉粥样硬化严重程度的升高，脑梗死患者血清纤维蛋白原及D-二聚体水平逐渐升高，差异有统计学意义（P＜0．05）；脑梗死患者血清纤维蛋白原、D-二聚体水平均与颈动脉粥样硬化严重程度呈正相关关系（r=0.426，P=0．006；r=0.535，P=0．001）。结论纤维蛋白原及D-二聚体参与了急性脑梗死的发生发展，与病情进展密切相关。二者做为急时相反应物参与动脉粥样硬化的发生机制提示，相对于高凝状态，动脉粥样硬化的形成与慢性炎症反应关系更为密切。
Objective To explore the correlation between fibrinogen, D-dimer and carotid atherosclerosis plaque in patients suffering acute cerebral infarction. Methods The present study enrolled 120 patients with acute cerebral infarction who had sought medical treatment in our department from April 2009 to April 2011 （group A）, 60 contemporary patients with carotid atherosclerosis plaque （group B） and 80 healthy adults who had undergone health check-ups at the same period （group C）. The level of serum D-dimer was detected by double antibody sandwich method, the fibrinogen content was detected by an automatic hemagglutination analyzer （STA-COMPACT, STAGO）, carotid atherosclerotic plaques and the carotid interior and medial thickness （IMT） were measured by carotid artery color Doppler ultrasound. Comparisons were made between the 3 groups. Results The serumal level of fibrinogen, D-dimer content and carotid IMT in the 3 groups decreased significantly from group A to B to C （P〈0.05）. The serumal levels of fibrinogen and D-dimer in the patients with progressive stroke were significantly higher than in the patients with non-progressing stroke （P〈0.05）. In patients with acute cerebral infarction, the severity of carotid atherosclerotic plaque was positively correlated with the serumal levels of fibrinogen and D-dimer （r=0.426, P=0.006; r=0.535, P=0.001）. Conclusions Fibrinogen and D-dimer may have a role in the occurrence and development of acute cerebral infarction and may be closely associated with the progression of the condition. Since D-dimer and fibrinogen arereactants at the acute phase, inflammation may be more related to atherosclerosis than is hypercoagulation.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2012年第3期266-268,共3页
Chinese Journal of Neuromedicine
