急性脑梗死患者血清Lp（a）、CRP、D-D、FG含量及临床意义

目的：探讨急性脑梗死与血中脂蛋白（a）[Lp（a）]以及C反应蛋白（CRP）、D-二聚体（D-D）和纤维蛋白原（FG）的关系。方法：在我院住院治疗的急性脑梗死患者335例，于入院次日清晨抽血检测其Lp（a）、CRP、D-D、FG的含量。同时选择性别和年龄相似的健康查体者作为对照组。比较不同梗死面积的急性脑梗死患者血液中Lp（a）、CRP、D-D、FG的水平。结果：①急性脑梗死组Lp（a）、CRP、D-D、FG的值分别为（425.13±85.11）mg/L、（16.32±5.21）mg/L、（285.11±116.33）ng/ml、（7.11±3.26）g/L，与对照组比较差异有显著性（P〈0.05或P〈0.01）。②不同梗死面积的急性脑梗死患者组间Lp（a）、CRP、D-D、FG的水平呈现大梗死灶〉小梗死灶〉腔隙性梗死的趋势，差异具有显著性（P〈0.05或P〈0.01）。结论：急性脑梗死的发生发展与血液中Lp（a）、CRP、D-D、FG的水平关系密切，Lp（a）、CRP、D-D、FG水平越高提示梗死面积越大，病情严重。Lp（a）、CRP、D-D、FG可作为急性脑梗死的危险因素，并可预测患者的梗死面积、病情严重程度。

Clinical Significance of Determination of Blood Lipoprotein(a),C-reactive Protein,D-dimer and Fibrinogen Levels in Patients with Acute Cerebral Infarction

Objective To investigate the relationship between the blood lipoprotein（ a）, C- reactive protein（ CRP）, D -dimer （ D - D）, fibfinogen（FG） levels and severity of acute cerebral infarction. Methods Serum Lp（a） （ with biochemistry）, CRP （ with rate scatter turbidiry method） and plasma FG （with biochemistry） D - D （with ELISA） levels were measured in 335 patients with acute cerebral infarction of different size （large over 3cm, n = 82, medium 15 -3.0cm n = 150 and minimal, below 1.5cm, n = 103 ） and 185 controls. Results （1） The blood Lp（ a）, CRP, D -D, FG and FG levels in patients with acute cerebral infarction were significantly higher than those in controls they were （425.13 ±85. 11）mg/L, （16.32±5.21） mg/L, （285.11 ± 116.33） ng/ml, （7.11 ± 3.26） g/L, respectively vs controls （ P 〈 0.05 or P 〈 0. 01 ）. （2） The blood levels of Lp （a）, CRP, FG and D - D in the patients were highest in the group of large size and lowest in the group of minimal lesion, the differences being significant （ P 〈 0.05 or P 〈 0. 01）. Conclusion The higher the blood Lp（a）, CRP, D -D and FG levels were, the larger the infarct size and the more severe the pathogenetic condition would be. Serum Lp（a）, CRP, D-D and FG levels were risk factors as well as prognostic markers for acute cerebral infarction and were clinically significant.