短暂性脑缺血发作患者脂蛋白(a)和D-二聚体水平的变化

目的探讨短暂性脑缺血发作(TC I)与血清脂蛋白(a)Lp(a)]和血浆D-二聚体(D-d im er)的关系。方法99例TC I患者按病程划分为A、B、C三组,所有病例均在起病24 h内采用酶联免疫吸附法(ELISA)检测血清Lp(a)和血浆D-二聚体的含量,观察72 h内头CT或MR I后与正常对照组进行比较,结果进行组间比较。结果TC I患者血清Lp(a)和D-二聚体的含量明显高于正常对照组(P<0.01),B、C组Lp(a)和D-二聚体的含量均高于A组(P<0.01),而且C组高于B组(P<0.0 5),重型患者明显高于轻、中型患者。TC I各组Lp(a)和D-二聚体含量之间的相关性分析显示,Lp(a)与D-二聚体含量均呈显著正相关(A组r=0.692,P<0.01;B组r=0.731,P<0.01;C组r=0.794,P<0.01)。结论Lp(a)可能是D-二聚体含量升高的主要相关因素,Lp(a)和D-二聚体含量的升高是TC I患者的危险因素,可作为TC I患者诊断、治疗和预后评估的指标。

The Fluctuation of Serum Lipoprotein(a) and Plasma D-dimer Levels in Patients with Transient Cerebral Ischemia

Objective To investigate the relationship between transient cerebral ischemia(TCI) and serum lipoprotein(a) and plasma D-dimer.Methods 99 patients with TCI were divided into three groups of A,B,C according to the course of the disease.All cases were detected within 24 hours of attack of the disease and serum Lp(a) and plasma D-dimer levels were determined by ELISA,head CT or MRI was carried out within 72 hours of attack of the TCI.Results The levels of serum Lp(a) and plasma D-dimer in patients with TCI were higher than those in control group(P<0.01),higher in B and C groups than in A group(P<0.01),higher in C group than in B group(P<0.05),showing the highest serum Lp(a) and plasma D-dimer levels in severe patients.The correlative analysis of all groups with TCI demonstrated that plasma D-dimer had obvious positive relationship with Lp(a).Conclusion The increased levels of Lp(а) and D-dimer were dangerous factors for the patients with TCI,Lp(a) and D-dimer may be a reliable index of laboratory observation for diagnosis,treatment and estimating prognosis.