联合检测同型半胱氨酸C反应蛋白D-二聚体及纤维蛋白原在急性脑梗死中的临床意义

目的：探讨同型半胱氨酸（ Hcy）、 C 反应蛋白（ CRP ）、D-二聚体（ DD ）及纤维蛋白原（ FBG）联合检测在急性脑梗死（ ACI ）中的临床意义。方法：纳入89例经临床及影像学确诊的ACI患者（ ACI组）和32例健康体检者（对照组），比较两组研究者及ACI 组不同梗死面积患者血浆Hcy、CRP、DD及FBG水平的差异，分析ACI组患者血浆Hcy、CRP、DD及FBG水平之间的相关性。结果：ACI组患者Hcy、CRP、DD、FBG水平均较对照组显著升高（ P＜0．05、P＜0．01）；ACI中梗死面积组及大梗死面积组患者血浆Hcy、CRP、DD及FBG水平均显著高于小梗死面积组（ P＜0．05、P＜0．01），而大梗死面积组患者血浆Hcy、CRP、DD及FBG水平显著高于中梗死面积组（ P＜0．05）；ACI患者血浆Hcy水平与CRP、DD、FBG水平均呈正相关（ r＝0．512、0．553、0．491， P＜0．05）。结论：血浆Hcy、CRP、DD及FBG水平与ACI的发生及发展密切相关，四者联合检测有助于临床诊断急性脑梗死并判断梗死面积，指导ACI的诊断及治疗。

Significance of Determining Homocysteine CRP D-dimer and Fibrinogen in Patients with Acute Cerebral Infarction

Objective： To explore the clinical significance of combined determining homocysteine （Hcy）, C-reactive protein （CRP）, D-dimer （DD） and fibrinogen （ FBG） in acute cerebralinfarction （ ACI） .Method： A total of 89 patients with ACI confirmed by clinical symptom and image data （ ACI group） and 32 healthy examines （control group） were enrolled in this study, the differences of plasma Hcy, CRP, DD and FBG between ACI groupand control group and ACI patients with difference infarct size were compared , and then the correlations between plasma Hcy, CRP, DD and FBG were also analyzed.Result：The Hcy, CRP,DD and FBG levels of ACI group were statistically higher than those of control group （P〈0. 05, P〈0.01）; median and large infarctsize group showed higher plasma Hcy, CRP, DD and FBG levels compared with small infarct size group （ P〈0 .05 , P〈0 .01 ） , and large infarct size group showed obviously higher plasma Hcy, CRP, DD and FBG levels than median infarct size group （P〈0.05）.There were posi-tive correlations between Hcy and CRP, DD, FBG in patients with ACI （r=0.512, 0.553, 0.491, P〈0. 05 ） .Conclusion：Plasma Hcy, CRP, DD and FBG levels are closely related with the occurrence and devel-opment of ACI, combined determination of the above four indexes can help to diagnose ACI, judge infarct size and guide the diagnosis and treatment of ACI.