同型半胱氨酸联合D二聚体检测在脑卒中诊治中的临床价值

目的探讨同型半胱氨酸(Hcy)联合D二聚体(D-D)检测在脑卒中诊治中的临床价值。方法纳入2017年5月～2018年5月我院住院部86例脑卒中患者作为观察组研究对象,纳入同时期我院体检中心50例健康志愿者作为对照组研究对象。比较两组入选者血清Hcy及血浆D-D水平差异,进一步按照脑卒中类型、脑卒中分期以及病灶直径将观察组患者进行分组,比较血清Hcy及血浆D-D水平差异,并分析Hcy、D-D水平与脑卒中分期以及病灶直径的相关性。结果观察组患者Hcy、D-D水平均高于对照组,差异显著(P0.05);缺血性脑卒中与出血性脑卒中患者Hcy、D-D水平均高于对照组,差异显著(P0.05);但缺血性脑卒中与出血性脑卒中患者Hcy、D-D水平并无统计学差异(P0.05);脑卒中患者Hcy、D-D水平急性期亚急性期慢性期,差异显著(P0.05);经Spearman检验Hcy、D-D与脑卒中病情严重度均呈明显正相关(r=0.781,r=0.542,P0.05);脑卒中患者Hcy、D-D水平病灶直径4 cm组病灶直径1.5～4 cm组病灶直径1.5 cm组,差异显著(P0.05);经Spearman检验Hcy、D-D与脑卒中病灶直径均呈明显正相关(r=0.752,r=0.503,P0.05)。结论 Hcy与D-D检测可作为诊断和评估患者病情的可靠依据,也可指示治疗效果。

Clinical value of homocysteine combined with D-dimer detection in the diagnosis and treatment of stroke

Objective To investigate the clinical value of homocysteine(Hcy)combined with D-dimer(D-D)detection in the diagnosis and treatment of stroke.Methods 86 stroke patients in the inpatient department of our hospital from May 2017 to May 2018 were included as the observation group.50 healthy volunteers from the medical examination center of our hospital were included as the control group at the same time.The differences of serum Hcy and plasma D-D levels between the two groups were compared.The patients in the observation group were further divided according to stroke type,stroke stage and lesion diameter.The differences of serum Hcy and plasma D-D levels were compared.The correlation of Hcy,D-D levels and stroke staging,lesion diameter was analyzed.Results The levels of Hcy and D-D in the observation group were significantly higher than those in the control group(P<0.05).The levels of Hcy and D-D in ischemic stroke and hemorrhagic stroke were significantly higher than those in the control group(P<0.05).However,there was no significant difference in Hcy and D-D levels between patients with ischemic stroke and hemorrhagic stroke(P>0.05).Hcy,D-D levels in stroke patients were the acute phase>subacute phase>chronic phase,and the difference was significant(P<0.05).Spearman test showed that Hcy,D-D were significantly positively correlated with stroke severity(r=0.781,r=0.542,P<0.05).The Hcy,D-D levels in stroke patients were lesion diameter more than 4 cm group>lesion diameter 1.5-4 cm group>lesion diameter less than 1.5 cm group,and the difference was significant(P<0.05).Spearman test showed that Hcy and D-D were significantly positively correlated with stroke lesion diameter(r=0.752,r=0.503,P<0.05).Conclusion Hcy and D-D detection can be used as a reliable basis for the diagnosis and evaluation of patients''conditions,and can also indicate the therapeutic effect.