几种常见面瘫患者血浆纤维蛋白原的检测  

Plasma fibrinogen in patients with facial paralysis

作　　者：李健东[1] 李娟[1] 刘永亮[1] 

机构地区：[1]北京世纪坛医院耳鼻咽喉头颈外科面神经研究室

出　　处：《中国耳鼻咽喉头颈外科》2010年第5期240-242,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的研究几种常见周围性面瘫患者的血浆纤维蛋白原水平，并探讨其与面瘫发病机制之间的关系。方法选择2006年12月-2008年12月在我科以面神经麻痹为主要诊断人院的患者共计157例按照病因及病情轻重分为Bell麻痹重症组60例，Bell麻痹轻症组19例，Hunt综合征组28例、颞骨骨折组28例，肿瘤性面瘫组22例。人院后检测血浆纤维蛋白原水平。结果耳带状疱疹、良性面神经肿瘤、颞骨骨折、Bell麻痹轻症组患者血浆纤维蛋白原水平正常。Bell麻痹重症组纤维蛋白原水平（4．08±0．90）g／L明显高于其他各组，差异有统计学意义伊〈05），且高于正常参考值范围2．0～4．0g／L。结论病情严重的贝尔面瘫患者血浆纤维蛋白原水平升高，由此产生的高凝状态将加重面神经微循环障碍，可能是保守治疗无效的主要因素之一。耳带状疱疹、良性面神经肿瘤、颢骨骨折患者血浆纤维蛋白原水平正常。Bell麻痹轻症组水平正常，预示着纤维蛋白原检测可能在贝尔面瘫预后方面有一定作用，建议作为Bell麻痹的临床必检项目，早期降纤及改善微循环可能是重症Bell麻痹患者新的治疗路径。OBJECTIVE To study the level of plasma fibrinogen in patients with common facial paralysis, and investigate the relationship between the plasma fibrinogen and the pathogenesis of facial paralysis. METHODS A total of 157 inpatients with different kinds of facial paralysis were studied from December 2006 to December 2008. They were etiologically divided into five groups： severe Bell＇s palsy group （60 cases） , moderate Bell＇s palsy group （19 cases） , Ramsay-Hunt syndrome group （28 cases） , temporal bone fracture with facial palsy （28 cases） , and facial nerve tumor group （22 cases） . They were tested for plasma fibrinogen level right after admitted to hospital. RESULTS Plasma fibrinogen level in severe Bell＇s palsy group was （4.08±0.90） g/L, which was significantly higher than that in other groups and the normal value （2.0N4.0） g/L （P〈0.05） . The other parameters of blood coagulation included PT, APTT, and TT had no significantly difference among 5 groups. CONCLUSION The level of plasma fibrinogen are higher in severe Bell＇s palsy patients, that may aggravate the microcirculation disorder inner the facial nerve canal, and may be one of the reasons for invalidation conservative treatments in these patients. In moderate Bell＇s palsy group, the level of plasma fibrinogen is normal, that indicate the level of plasma fibrinogen may be a useful prognostic test in Bell＇s palsy. The levels of plasma fibrinogen are normal in Ramsay-Hunt syndrome, temporal bone fracture, and facial nerve tumor groups. The level of plasma fibrinogen should become a routine test in facial paralysis, and defibrinogen medication may be a new treatment approach in the early stage of the Bell＇s palsy.

关 键 词：面神经麻痹 Bell麻痹 纤维蛋白原 

分 类 号：R745.12[医药卫生—神经病学与精神病学]