急性脑梗死患者同型半胱氨酸及凝血纤溶相关指标的检测及意义

目的：探讨同型半胱氨酸（Hcy）、凝血及纤溶指标对判断急性脑梗死疾病的进展与预后的意义.方法：收集45例急性脑梗死患者（急性脑梗死组）和30例健康体检者（对照组）外周血,检测血浆中Hcy、纤维蛋白原、D-二聚体和纤溶酶原的含量,采用美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin量表（mRS）评分对急性脑梗死患者疾病的进展及预后进行评估和分组,观察不同预后与不同进展各组患者血浆Hcy、纤维蛋白原、D-二聚体和纤溶酶原的含量变化.结果：急性脑梗死组患者血浆Hcy、纤维蛋白原、D-二聚体含量高于对照组,差异有统计学意义（P＜0.01）;急性脑梗死组患者血浆中纤溶酶原的含量低于对照组,差异有统计学意义（P＜0.01）;与急性脑梗死疾病进展组相比,非进展组患者的Hcy、纤维蛋白原及D-二聚体含量较低,纤溶酶原含量较高,差异有统计学意义（P＜0.05）;急性脑梗死患者预后良好组与不良组的Hcy、纤维蛋白原及纤溶酶原的差异无统计学意义（P＞0.05）,预后良好组D-二聚体含量较预后不良组明显降低,差异有统计学意义（P＜0.05）.结论：检测Hcy及凝血纤溶相关指标的含量可有效判断急性脑梗死患者病情、预后和进展,D-二聚体含量与患者的预后相关.

Clinical Significance of Detection of Homocysteine Levels,Coagulation and Fibrinolysis Indexes of Patients with Acute Cerebral Infarction

Objective：To explore the clinical significance of homocysteine level,parameters of coagulation and fibrinolysis in estimating disease progress and prognosis of patients with acute cerebral infarction.Method：The blood samples of 45 patients with acute cerebral infarction and 30 healthy controls were collected,and the levels of homocysteine,fibrinogen,D-dimer and plasminogen were detected.Disease progress and prognosis of patients with acute cerebral infarction were estimated with American national institutes of health stroke scale （NIHSS） score and modified Rankin scale （mRS）.The levels of homocysteine,fibrinogen,D-dimer and plasminogen of patients with different progress and prognosis were compared.Results：The levels of homocysteine,fibrinogen and D-dimer in peripheral blood of patients with acute cerebral infarction were significantly higher than those of the healthy control group（P ＜0.01）,and the level of plasminogen was significantly lower than the control group （P ＜ 0.01）.The levels of homocysteine,fibrinogen and D-dimer in peripheral blood of patients in disease non progress group were significantly lower than those of patients in disease progress group （P ＜ 0.05）,and the level of plasminogen was significantly higher than disease progress group （P ＜ 0.05）.No significant difference was found in the levels of homocysteine,fibrinogen,and plasminogen between patients with good prognosis and bad prognosis （P ＞ 0.05）.D-dimer levels in patients with good prognosis were lower than those in patients with bad prognosis（P ＜ 0.05）.Conclusions：Detection of homocysteine levels,coagulation and fibrinolysis parameters contribute to the diagnosis and progress estimating of acute cerebral infarction,and serum D-dimer level was correlated with the prognosis of disease.