心房颤动并发脑栓塞的严重程度与纤维蛋白原的相关性

目的探讨心房颤动并发脑栓塞患者严重程度与血浆纤维蛋白原(Fib)的相关性。方法收集住院治疗的合并心房颤动的脑栓塞患者80例,于入院时查血浆Fib,并行美国国立卫生研究院卒中量表(NIHSS)评分,分析两者之间的相关性。定义NIHSS评分≥15分为重症脑栓塞,Logistic回归分析其与Fib的危险相关度。入组患者经牛津郡社区卒中计划(OCSP)分型后,以腔隙性梗死作为参照,Logistic回归分析其他亚型Fib的水平相对危险度。结果脑栓塞患者Fib与NIHSS评分具有显著相关性(r=0.264,P<0.05)。重症脑栓塞与Fib的单因素回归分析显示OR(95%CI)为2.404(1.107-5.222),经性别、年龄、高血压、糖尿病多因素校正后为3.292(1.322-8.200)(P<0.05)。完全前循环梗死组Fib水平是腔隙性梗死组的3.166倍(95%CI为1.259-7.961,P<0.05)。结论血浆Fib水平可一定程度的反映房颤并发脑栓塞患者的病情严重程度。

Correlation between the severity of stroke and fibrinogen in atrial fibrillation patients with cerebral embolism

Objective To investigate the correlation between the severity of stroke and fibrinogen in atrial fibrillation(AF) patients with cerebral embolism.Methods Plasma fibrinogen was detected and NIHSS scores were recorded in 80 AF patients with cerebral embolism,in whom the correlation between plasma fibriogen and stroke severity of cerebral embolism was analyzied.Taking NIHSS score≥15 as a severe cerebral embolism,the relative riskiness between NIHSS and fibrinogen was analyzed with Logistic regression analysis.In the OCSP subtype of stroke,taking Lacunar infarction as reference,the relative riskiness was analyzed among other subtypes after the patients were subtyped with OCSP.Results Plasma level of fibrinogen was closely correlated to NIHSS(r=0.264,P<0.05).Logistic regression analysis revealed that OR(95%CI) between severe cerebral embolism and plasma fibrinogen was 2.404(1.107-5.222),which was 3.292(1.322-8.200) after adjusted by age,sex,HBP and DM(P<0.05).Plasma level of fibrinogen in the cases with total anterior circulation infarction was 3.166 times as that in those with Lacunar infarction(95% CI=1.259-7.961,P<0.05).Conclusion Plasma fibrinogen levels can reflect the severity of AF patients with cerebral embolism in certain degrees.