缺血性脑梗死患者D-二聚体定量检测的临床研究

目的:了解缺血性脑梗死患者在不同阶段血浆D-二聚体测定的意义。方法:随机选择42例到本院神经内科就诊的缺血性脑梗死患者(年龄53~90岁,男21例,女21例),分别于急性期(<6天,n=27,年龄53~87岁)和亚急性期(6~20天,n=15,年龄51~90岁)行血浆D-二聚体测定。患者均经头颅CT证实为缺血性脑梗死。同时选择年龄相匹配的20例其他非凝血及血栓性疾病患者(年龄61~87岁)作为对照组。结果:缺血性脑梗死患者的血浆D-二聚体水平在急性期未见升高(<0.5mg/L),而在亚急性期显著升高(≥0.5mg/L,0.5~2mg/L),亚急性期与对照组(<0.5mg/L)比较差异有显著性(P<0.001),与急性期比较差异也有显著性(P<0.001)(正常值为<0.5mg/L)。结论:缺血性脑梗死患者的纤溶系统显著激活并非在急性期,而是在亚急性期。这也为急性期进行溶栓治疗提供了依据。

Clinical study of quantitative detection of D - dime in plamm of patients with cerebral ischemic infarction

Objective:The purpose of this study was to clarify differences in fibrinolytic activation among the various phases of cerebral ischemic infarction.Methods:D-dimer were measured in42patients with cerebral ischemic infarction(5190years,men21,female21)and20age-matched controls.All42patients were divided into two groups,27cases were during acute phases(<6days)and15cases were during subacute phases(620days).Results:The levels of D-dimer were significantly higher(0.5mg/L,0.52mg/L)during subacute phases of cerebral ischemic infarction than those in the controls(<0.5mg/L,P<0.0001),however,the levels of D-dimer were not elevated(<0.5mg/L)during the acute phases of cerebral ischemic infarction(normal was<0.5mg/L),which were less than those during subacute phases(P<0.0001).Conclusion:Our findings suggested that fibrinolytic activations were significantly increased during subacute phases of cerebral ischemic infarction,and were not increased during acute phase.