缺血性脑血管病患者纤维蛋白单体聚合功能及康复介入的影响

目的　研究缺血性脑血管病患者纤维蛋白单体聚合功能的临床意义及康复介入的影响。方法　检测 110例不同类型缺血性脑血管病患者、及其中 31例脑梗死患者康复介入前后和 5 0例健康人的纤维蛋白单体聚合功能参数。结果　缺血性脑血管病患者较健康人纤维蛋白单体聚合功能各项参数均显著增高(P <0 .0 1) ;缺血性脑血管病患者纤维蛋白原 (Fbg)水平和纤维蛋白单体聚合速率 (FMPV)的异常率较健康人显著增高 (P <0 .0 1) ,Fbg水平异常和纤维蛋白单体聚合功能异常患者缺血性脑血管病的相对危险度 (RR)分别是健康对照组的 4和 31倍 ;脑梗死患者中 ,前循环梗死组FMPV较后循环梗死组和腔隙性脑梗死组显著升高 (P <0 .0 5 ) ;康复介入前脑梗死患者纤维蛋白单体聚合功能显著高于健康对照组 ,康复介入后纤维蛋白单体聚合功能各参数有所降低 ,但与治疗前无显著性差异。结论　纤维蛋白单体聚合功能测定能更全面、客观地反映缺血性脑血管病患者的凝血状态 ,其异常幅度能在一定程度上反应梗死的范围和严重程度。尽管一般的康复介入不能有效改善血液的高凝状态 ,但随着医学技术的不断发展 ,特殊的康复介入对于血液凝血机制的影响值得进一步研究。

Study of fibrin monomer polymerization function and its variation after clinical rehabilitative interventions in patients with ischemic cerebrovascular disease

Objective To study the role of fibrin monomer polymerization function and its variation after clinical rehabilitative treatment in patients with ischemic cerebrovascular disease. Methods 110 patients were recruited for this study, of them 31 received rehabilitation treatment. 50 healthy subjects served as control. The fibrin monomer polymerization function was assessed by a computer-assisted procedure in all the subjects. Results Fibrin monomer polymerization function of patients with ischemic cerebrovascular disease was significant higher than the controls(P<0.01). Abnormal incidences of Fbg level and fibrin monomer polymerization velocity (FMPV) in patients with ischemic cerebrovascular disease were also significantly higher than the controls (P<0.01). The relative risk of ischemic cerebrovascular disease patients with abnormal Fbg level and FMPV was 4 and 31 times of that of the control group. In patients with cerebral infarct, FMPV of anterior circulation infarct group was significant higher than posterior circulation infarct group and lacunar infarct group. After rehabilitation treatment, parameters of fibrin monomer polymerization function of the 31 patients who received rehabilitation treatment decreased slightly, but the difference was not significant. Conclusion It is suggested that fibrin monomer polymerization function could be a very useful marker for evaluation of hemotological state and the outcome of patients with ischemic cerebralvascular disease.