进展型脑梗死患者凝血功能、D-二聚体、血脂水平及其临床意义

目的探讨进展型脑梗死患者凝血功能、D-二聚体、血脂水平及其临床意义。方法急性脑梗死患者94例,按病程分为进展型脑梗死组（43例）和完全型脑梗死组（51例）,另选取同期体检健康者45例为正常对照组。采用双抗体夹心酶联免疫吸附法（ELISA）检测凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血酶时间（APTT）与纤维蛋白原（Fib）;采用胶体金法测定血浆D-二聚体水平;采用雅培全自动生化分析仪测定血总胆固醇（TC）、甘油三酯（TG）、高密度胆固醇（HDL-C）与低密度胆固醇（LDL-C）水平。结果进展型脑梗死组患者PT、TT、APTT水平均低于完全型脑梗死组与正常对照组（P〈0.05）,Fib与D-二聚体水平则高于完全型脑梗死组与正常对照组（P〈0.05）。完全型脑梗死组PT、TT、APTT水平及Fib、D-二聚体水平与正常对照组相比,差异无统计学意义（P〉0.05）。进展型脑梗死组患者血脂TC、TG、LDL-C水平均高于完全型脑梗死组与正常对照组（P〈0.05）,HDL-C水平与完全型脑梗死组及正常对照组相比,差异无统计学意义（P〉0.05）。完全型脑梗死组患者血脂TC、TG、LDL-C水平亦高于正常对照组（P〈0.05）,HDL-C水平与正常对照组相比,差异无统计学意义（P〉0.05）。结论血液中凝血指标、D-二聚体与血脂水平的动态变化与疾病病情相关,对评估预后有重要价值。

Coagulation,D-Dimer and Blood Lipid Levels in Patients with Progressive Cerebral Infarction and Their Clinical Significance

Objective To investigate the coagulation,D-dimer and blood lipid levels in patients with progressive cerebral infarction and their clinical significance. Methods Ninety-four patients with cerebral infarction were divided into progressive cerebral infraction group（ 43 cases） and completely cerebral infraction group（ 51 cases） according to the treatment course,and 45 healthy cases in the same period were selected as control group. Enzyme-linked immunosorbent assay（ ELISA）was used to detect prothrombin time（ PT）,thrombin time（ TT）,activated partial thromboplastin time（ APTT） and fibrinogen（Fib）.The D-dimer level was detected by colloidal gold method. The levels of TC,TG,HDL-C and LDL-C were tested by Architect automatic biochemistry analyzer. Results The levels of PT,TT and APTT in the progressive cerebral infraction group were significantly lower than those in the completely cerebral infraction group and control group（ P 〈 0. 05）,the levels of Fib and D-dimer were significantly higher than those in the completely cerebral infraction group and control group（ P 〈 0.05）. There was no significant difference in the levels of PT,TT,APTT,Fib and D-dimer between completely cerebral infraction group and control group（ P 〈 0. 05）. The levels of TC,TG and LDL-C in the progressive cerebral infraction group were higher than those in the completely cerebral infraction group and control group（ P 〈 0. 05）,while the HDL-C level showed no statistically significant difference in contrast with that in the completely cerebral infarction group or control group（ P 〈 0. 05）. The levels of TC,TG and LDL-C in the completely cerebral infarction group were higher than those in the control group（ P 〈 0. 05）,while the HDL-C level showed no statistically significant difference in contrast with that in the control group（ P 〈 0. 05）. Conclusion The dynamic changes in the coagulation,D-dimer and blood lipid levels are closely associated with the severity of the disease,and it is