动态检测进展性脑梗死患者血清C-反应蛋白和D-二聚体的价值

目的探讨动态观察血C-反应蛋白（CRP）、D-二聚体（DD）的变化对进展性脑梗死的价值。方法选择2012年2月～2013年1月辽宁省鞍山市双山医院收治的进展性脑梗死患者60例为观察组,同期非进展性脑梗死患者60例为对照组,分别检测患者入院次日（第1天）、第3天、第7天和第14天血CRP和DD含量的动态变化。结果①观察组患者入院时颈动脉狭窄的比例为43.3%（26/60）,明显高于对照组的30.0%（18/60）,差异有高度统计学意义（P〈0.01）;观察组患者入院时血总胆固醇（TC）、三酰甘油（TG）和低密度脂蛋白胆固醇（LDL-C）明显高于对照组,差异有高度统计学意义（P〈0.01）;高密度脂蛋白胆固醇（HDL-C）和血糖水平两组比较差异无统计学意义（P〉0.05）。两组患者血CRP和DD水平在第1天差异无统计学意义（P〉0.05）。②对照组第3、7、14天CRP水平低于第1天,差异有统计学意义（P〈0.05）;观察组第3、7天CRP水平高于第1天,差异有统计学意义（P〈0.05）;观察组第14天CRP水平与第1天比较差异无统计学意义（P〉0.05）。观察组第3、7、14天DD水平高于第1天,且观察组水平明显高于同时间对照组,差异有统计学意义（P〈0.05）。结论动态观察CRP和D-二聚体的变化有助于进展性脑梗死的早期识别和及时处理。

Value of dynamic detection of serum C-reactive protein and D-dimer in patients with progressive cerebral infarction

Objective To explore the value of dynamic detection of serum C-reactive protein and D-dimer in patients with progressive cerebral infarction. Methods 60 cases of progressive cerebral infarction patients in Shuangshan Hos-pital of Anshan City from February 2012 to January 2013 were selected as observation group and 60 cases of patients with non-progressive cerebral infarction were selected as control group. Blood C-reactive protein, D-dimer levels in the two groups were measured at next day （day 1）, day 3, day 7 and day 14. Results @Carotid stenosis rate in obser- vation group was 43.3%（26/60） in day 1, carotid stenosis rate in control group was 30.0%（18/60）, the difference was statistically significant （P 〈 0.01）; TC, TG, LDL-C in observation group in day 1 were higher than those in control group, the differences were statistically significant （P 〈 0.01）; the differences of HDL-C, blood glucose level in the two groups in day 1 were not statistically significant （P 〉 0.05）. The differences of CRP and DD level in the two groups in day 1 were not statistically significant （P 〉 0.05）. ②CRP in control group in day 3, 7, 14 were lower than those in day 1, the differences were statistically significant （P 〈 0.05）; CRP in observation group in day 3, 7 were higher than those in day 1, the differences were statistically significant （P 〈 0.05）; the difference of CRP in observation group in day 1 and day 14 was not statistically significant （P 〉 0.05）; DD levels in observation group in day 3, 7,14 were higher than those in day 1, DD levels in observation group were higher than those in control group in the same term, the differ-ences were statistically significant （P 〈 0.05）. Conclusion The dynamic observation of the changes of CRP and DD may contribute to early identification and timely treatment of progressing ischemic stroke.