早期进展性脑梗死患者血浆D-二聚体水平变化

目的探讨血浆D-二聚体(D-dimer,DD)在早期进展性脑梗死发病中的作用。方法发病24 h内入院的急性脑梗死(ACI)患者87例,分为早期进展组31例,非早期进展组56例。采用酶联免疫吸附试验动态监测患者入院即刻和第3天的血浆DD浓度,同时采用斯堪的那维亚卒中量表(SSS)进行神经功能缺损评分。结果早期进展组入院即刻、第3天的血浆DD水平均高于非早期进展组(P<0.01)。2组入院第3天DD水平高于入院即刻(P<0.01)。在早期进展性脑梗死相关因素的Logistic回归分析中,入院即刻DD可作为独立预测ACI早期进展的因素(P<0.05)。早期进展性脑梗死患者DD水平与SSS下降分值呈直线正相关(P<0.01)。结论急性脑梗死患者血浆DD水平升高,血浆DD水平值可作为急性脑梗死患者早期进展的标志物。

Changes of level of plasma D-dimer in patients with early progressing cerebral infarction

Objective To investigate the role of plasma D-dimer in pathogenesis of early progressing cerebral infarction. Methods Eighty-seven patients with acute cerebral infarction within 24 hours from onset were divided into early progressing group(n = 31) and no early progressing group(n = 56).Plasma D-dimer levels were measured by enzyme linked immunosorbent assay at admission and the third day,and the severity of stroke was scored using the scandinavian stroke scale(SSS).Results Plasma D-dimer levels of patients in early progressing group at admission onset and the third day were significantly higher than those of patients in no early progressing group(P<0.01).Plasma D-dimer level of the third day was higher than that of admission onset(P<0.01).In logistic regression analysis of relative variables of early progressing cerebral infarction,plasma D-dimer of admission onset remained independent predictors of early progressing stroke(P<0.05).There was a positive correlation between average D-dimer level and SSS falling scores in patients with early progressing cerebral infarction(P<0.01).Conclusion Plasma D-dimer levels are significantly elevated in patients with acute cerebral infartion.Plasma D-dimer level can be regarded as a marker of early progressing cerebral infarction.