急性脑血管病患者治疗前后血浆D-二聚体的变化及临床意义

目的研究纤溶指标D-二聚体（D—dimer，D—D）抗原含量在急性脑梗死（CI）、脑出血（CH）及短暂性脑缺血发作（TIA）患者血浆中治疗前后的变化及其临床意义。方法用酶联免疫吸附双抗体夹心法（ELISA）分别检测30例脑梗死、20例脑出血及15例短暂性脑缺血发作（TIA）患者治疗前后血浆D-二聚体的抗原含量水平并分别与对照组比较。结果脑梗死、脑出血急性期血浆D-二聚体水平均高于对照组，两组之间差异无统计学意义；治疗后两组D-二聚体含量降低，TIA组D-二聚体含量变化无统计学意义。结论血浆D-二聚体是反映体内纤溶状态、纤溶活性的重要指标，在不同的疾病和病期有不同的变化，可作为判断病情严重程度、预后与复发及判断病程、病期的参考指标；D-二聚体单独应用不能鉴别急性脑梗死和脑出血。

D- Dimer changes in cerebrovascular dsease and its clinical significnce

Objective To study the clinical significance of plasma levels of D - dimer （ D - D ） in patients with transient ischemic attack （TIA）, cerebral infarction （CI） and cerebral hemorrhage （CH）. Methods Fibrinolysis markers of D -D in plasma of 30 cases of cerebral infarction （CI） ,20 cases of cerebral hemorrhage （CH） ,15 cases of transient iscbemic attack（TIA） patients before and after treatment were tested by enzyme - linked immunosorbent assay （ ELISA）, and compared with control group. The difference was considered to be statistically significant. Results Compared with the control group, the plasma level of markers of D -D increased significantly in group of CI and CH（P 〈0. 05） ,but there were no difference between two groups. After treatment, the plasma level of D - D degraded in group of CI and CH （ P 〈 0. 05 ）, and compared with control group, there was no significant difference. There was no changes in TIA before and after treatment compared with the control group. Conclusion D - D is an important indexes that correlates with fibrinolysis markers in vivo. It can be used as a referent index to evaluate patient＇s prognosis, recurrence ,course and stage of disease. It also should be used as the quick and cheap referent indexes to diagnose cerebral infarction in early stage,but it can not be used to identify CH and CI.