心肌酶谱联合纤维蛋白原和D-二聚乍在脑梗死患者检测中的意义

目的观察心肌酶谱联合纤维蛋白原和D-二聚体在脑梗死患者检测中的意义。方法2009年1月-2012年1月在上海市第一人民医院宝山分院就诊的脑梗死患者120例为脑梗死组，根据临床神经功能缺损程度评分标准分为轻型组24例、中型组52例和重型组44例；根据Pullicino公式计算梗死灶面积分为小梗死灶组51例，中梗死灶组45例和大梗死灶组24例。同时选择同期30名健康体检者为对照组。观察两组心肌酶谱、纤维蛋白原和D-二聚体的变化。结果脑梗死组的心肌酶谱、纤维蛋白原和D-二聚体的水平较对照组明显提高，差异有高度统计学意义（P〈0．01）。心肌酶谱、纤维蛋白原和D-二聚体水平随着神经缺损程度和脑梗死灶大小的升高而升高，差异有统计学意义（P〈0．05或P〈0．01）。结论心肌酶谱、纤维蛋白原和D-二聚体水平联合检测有助于了解脑梗死病情及心脏受累程度，作为评价急性脑梗死发生、发展以及监测病情严重程度的重要指标，对临床的诊断、治疗具有重要参考价值。

Significance of myocardial enzymes combined with fibrinogen and D-dimer in patients with cerebral infarction

Objective To investigate the significance of myocardial enzymes combined with fibrinogen and D-dimer in patients with cerebral infarction. Methods 120 patients with cerebral infarction as cerebral infarction group in Baoshan Branch of Shanghai First People＇s Hospital from January 2009 to January 2012 were chosen as cerebral in- farction group, the patients were divided into mild group （24 cases）, medium group （52 cases） and severe group （44 cases） according to the clinical neurological deficit scores; and were divided into small cerebral infarction （51 cases）, medium cerebral infarction （24 cases） and large cerebral infarction （45 cases） according to the Pullicino formula for in- farct area. 30 healthy persons at the same period were selected as control group. The levels of myocardial enzymes, fibrinogen and D-dimer changes were detected in two groups. Results In cerebral infarction group, the levels of my- ocardial enzymes, fibrinogen and D-dimer were markedly increased, and the differences were statistically significant different （P 〈 0.01）. The levels of myocardial enzymes, fibrinogen and D-dimer increased as the degree of nerve de- fects and infarct size increased, the differences were statistically significant different （P 〈 0.05 or P 〈 0.01）. Conclu- sion It is helpful to understand the patient＇s condition of cerebral infarction and the degree of cardiac involvement through the myocardial enzymes combined with fibrinogen and D-dimer, which are important indicators of the acute cerebral infarction for monitoring of the severity and development in cerebral infarction, it is of important reference value for clinical diagnosis and treatment.