脑梗死患者血浆D-二聚体和稀醇化酶含量变化及临床意义

目的 探讨血浆D-二聚体、神经元特异性稀醇化酶(NSE)对血栓形成性脑梗死(CI)、梗死体积、神经功能缺损程度影响的临床意义.方法 应用酶联免疫吸附试验双抗体夹心法,对66例CI患者不同发病时期及46例正常人血浆D-二聚体、NSE含量进行分析;对不同梗死体积、不同神经功能缺损程度CI患者血浆D-二聚体、NSE含量进行分析.结果 CI患者发病48 h内血浆D-二聚体、NSE含量显著高于正常人(P<0.01),第5天增高最显著(P<0.001),第18天无显著差异.CI患者大、中梗死组及中、重型神经功能缺损组血浆D-二聚体、NSE含量显著高于小梗死组及轻型神经功能缺损组(P<0.001).结论 CI患者血浆D-二聚体、NSE含量增高,与机体高凝状态和脑组织神经元坏死密切相关,是CI发生、发展重要病理学基础.血浆D-二聚体、NSE含量明显升高,导致大梗死灶及重度神经功能缺损.D-二聚体,NSE两种特异性标志物,可早期诊断CI,有效评价患者病情程度.

Changes of plasma cross-linked D-dimer and neuron-specific enolase in patients with cerebral infarction

OBJECTIVE: To explore the effect of plasma cross-linked D-dimer (XDP) and neuron-specific enolase (NSE) on the infarct volume and neurological function deficit in patients with cerebral infarction (CI). METHODS: Plasma XDP and NSE levels were measured in 66 CI patients on the different days after onset and also in 46 normal individuals, and the changes in XDP and NSE levels were analyzed in the CI patients with different infarct volume and neurological function deficit scores. RESULTS: Within 48 h following CI onset, plasma XDP and NSE levels increased significantly (P<0.01) and reached the highest levels on day 5 (P<0.001), recovering the normal level till day 18. Plasma XDP and NSE levels were significantly higher in patients with moderate to large infarct volume and in those with moderate to severe neurological deficits than in those with small infarct volume and mild neurological deficits (P<0.001). CONCLUSION: Increment of XDP and NSE levels is an important pathological process in CI in close relation to the infarct volume and neurological deficits. XDP and NSE may serve as reliable indices for early diagnosis and evaluation of CI.