脑卒中急性期Fib、PT、APTT、D-二聚体水平的变化及临床意义(1)
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[摘要] 目的：探讨脑卒中急性期Fib、PT、APTT、D-二聚体水平的变化及临床意义。方法：对82例急性脑梗死患者和66例急性脑出血患者，分别于发病后第1、3、7、14 d同步测定血浆Fib、PT、APTT、D-二聚体水平，并与50例健康对照者进行比较。结果：脑卒中组第1、3、7 d Fib、D-二聚体水平均高于对照组(P<0.05)，且二者呈强相关性。PT、APTT水平在脑卒中组及对照组中差异无统计学意义(P>0.05)。结论：脑卒中急性期与对照组比较Fib、D-二聚体均有增高，提示凝血功能异常可能与脑卒中的发生有关。血浆Fib、D-二聚体水平可作为预测脑卒中危险系数的指标之一，且还可作为评判脑卒中治疗疗效的指标之一。
[关键词] 脑出血；脑梗死；纤维蛋白原；D-二聚体
[中图分类号] R743.3 [文献标识码] A [文章编号] 1674-4721(2011)11(c)-039-03
The change and clinical significance of Fib、PT、APTT and D-dimer in acute stroke
YI Honglin, HUANG Fang, CHEN Yaming
Department of Emergency, the Second People′s Hospital of Yueyang City, Hunan Province, Yueyang 414000, China
[Abstract] Objective: To explore the changes of Fib、PT、APTT and D-dimer in acute stroke and their clinical significance. Methods: The levels of Fib、PT、APTT and D-dimer were investigated 82 cases acute cerebral infarctions and 66 cases acute cerebral hemorrhages on the days of 1、3、7、14 d after getting ill, and the results were compared with the data from 50 cases healthy people. Rusults: The levels of Fib and D-dimer in the acute stroke group tested on the 1、3、7 d were all higher than those of the contrastive group (P<0.05). A positive correlation was shown between Fib and D-dimer. The levels of PT and APTT in the acute stroke group had no obvious difference from those of the contrastive group (P>0.05). Conclusion: The levels of Fib and D-dimer in acute stroke group are all higher than those of the contrastive group. It indicates that coagulation disorder may be associated with the occurrence of acute stroke, and suggests that Fib and D-dimer will serve as one of the objective indicators for predictiing the stoke and evaluating the effectiveness of stoke therapy. [Key words] Cerebral hemorrhage; Cerebral infarction; Fibrinogen; D-dimer
我国是脑卒中死亡率高发地区，据统计现有脑血管病患者约600万，每年新发约130万人，死亡达100万人，在幸存者当中约3/4的患者留下偏瘫、言语不清等后遗症状，部分患者丧失劳动能力，给家庭和社会带来沉重负担[1]。脑卒中重在预防，研究表明，急性脑血管疾病的发生、发展与高血压、高血糖及高血脂等诸多高危因素密切相关。近来研究发现脑卒中急性期机体处于一种应激状态，出现一系列生理变化，原有的凝血、抗凝及纤溶间的平衡被打破。随着凝血纤溶机制的研究进展，凝血纤溶功能的改变在脑卒中中的意义越来越引起人们的重视。本院急诊科于2010年7月～2011年5月对82例急性脑梗死患者和66例急性脑出血患者，分别于发病后第1、3、7、14 d同步测定血浆Fib、PT、APTT、D-二聚体水平 ......
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