不同溶栓效果患者纤维蛋白原及D-二聚体的动态变化研究

目的 探讨不同溶栓效果的急性脑梗死患者纤维蛋白原（FIB）及D-二聚体DD）动态变化.方法 根据治疗24 h后的神经功能缺损评分（NIHSS）减分率比较溶栓组33例与未溶栓组20例的疗效,采集溶栓组溶栓前,溶栓后2h、6h、12h、24 h及l周的血液检查FIB、DD水平,用重复测量方差分析其动态变化.结果 溶栓患者24 h后NIHSS减分率较未溶栓患者差异有统计学意义（x2=4.7026,P＜0.05）.溶栓效果好组FIB在12h达到低点,明显低于溶栓效果差组（￡=4.47,P＜0.01）,DD在6h达到高点,明显高于溶栓效果差组（t=6.374,P＜0.01）,其差异均有统计学意义.结论 溶栓效果好的患者FIB下降明显,DD上升明显,为临床观察病情转归,预测预后提供依据.

Dynamic variation of plasma fibrinogen and D-dimer in acute ischemic stroke patients after thrombolysis

Objective To explore the dynamic variation of plasma fibrinogen （FIB） and D-dimer （DD） in acute ischemic stroke patients after thrombolysis.Methods The therapeutic effect of the acute ischemic stroke patients with or without thrombolysis were compared by the national institutes of health stroke scale （NIHSS） reductive ratio 24 hs later.The FIB and DD were test before thrombolysis,2 h,6 h,12 h,24 h,and 1 week after thrombolysis.The data were analyzed by variance of repeated measurement.Results There was statistically significant difference of 24 h NIHSS reductive ratio between the patients with thrombolysis and non-thrombolysis.The FIB got the lowest point at 12 h after tbrombolysis in the group with good effect,significantly lower than the group with bad effect （t=4.473,P＜0.01）.The DD reached the highest point at 6 h after thrombolysis in the group with good effect,significantly higher than the group with bad effect （t=6.374,P＜0.01）.Conclusion The FIB decreases and DD increases significantly in the patients with thrombolysis who had good effect,and hence it can be used to estimate and predict the outcome of patients.