血浆纤维蛋白原检测在短暂性脑缺血发作预后判断中的应用  

Predictive value of the Level of Plasma Fibrinogen for the Outcome of Patients with Transient Ischemic Attack

作　　者：赵振强[1] 胡兰[1] 蔡美华[1] 陈志斌[1] 王淑荣[1] 王埮[1] 

机构地区：[1]海南医学院附属医院,海口570102

出　　处：《山东医药》2015年第3期11-13,共3页Shandong Medical Journal

基　　金：海南省自然科学基金项目(811217);海南省重大科技项目(ZDZX2013003);海南医学院科研培育基金项目(HY2010-025)

摘　　要：目的探讨血浆纤维蛋白原（FIB）检测在短暂性脑缺血发作（TIA）患者预后判断中的应用价值。方法选择急诊入院的132例TIA患者,均进行ABCD2评分,低危患者46例（0~3分）,中危患者70例（4~5分）,高危患者16例（6~7分）。采用全自动CA7000血凝仪检测TIA患者血浆FIB。患者预后采用复合终点事件来判断,包括在90 d内脑卒中或死亡、与症状相关≥50%大动脉狭窄或有心源性栓子需抗凝治疗。结果未发生复合终点事件98例（阴性组）,发生复合终点事件34例（阳性组）。阳性组与阴性组患者血浆FIB水平分别为（4.53±0.99）、（3.05±0.93）g/L,两组比较,P〈0.05。ABCD2评分为低危、中危、高危患者血浆FIB水平分别为（2.98±0.86）、（3.54±1.47）、（5.16±1.68）g/L,三者间比较,P均〈0.05。相关性分析结果显示,血浆FIB水平与ABCD2评分呈正相关（r=0.388,P〈0.001）。Cox回归分析结果显示,ABCD2≥4分及血浆FIB≥3.5 g/L是TIA患者发生复合终点事件的预测因素（P均〈0.05）。结论 TIA发生复合终点事件者血浆FIB水平明显升高,血浆FIB水平与ABCD2评分呈正相关。血浆FIB≥3.5 g/L时可有效判断90 d内TIA患者预后。Objective To explore the predictive value of the level of plasma fibrinogen （ FIB ） for the prognosis of pa- tients with transient ischemic attaek（TIA）. Methods 132 patients with acute TIA in hospitalization were enrolled. These patients were divided into low （0 ~3 points, 46 patients）, mederate （4 -5 points, 70 patients） and high （6 ~7 points, 16 patients） risk groups according to their ABCD2 scores. The levels of FIB were detected by using SYSTEX CA-7000 Au- tomated Blood Coagulation Analyzer. The primary outcome measure was a composite endpoint consisting of stroke or death within 90 days; ≥50% stenosis in a artery association with clinical symptoms or cardioembolic source warranting anticoagu- lation. Results The composite end point occurred in 34 patients （ positive group ） and was not found in other 98 patients （ negative group ）. The level of FIB was higher in positive group compared to negative group [ （4.53±0.99） vs （3.05 ± 0.93 ） g/L, P 〈 0. 05 ]. There was significant difference among low-risk, mederate-risk and high-risk groups in the levels of plasma FIB [ （2.98 ± 0.86） vs （3.54± 1.47） vs （5.16 ± 1.68） g/L, P 〈 0.05 ]. Spearman rank correlation coefficient test showed that the level of plasma FIB was positively correlated with ABCD2 score （ r = 0. 388, P 〈 0. 001 ）. Cox regres- sion analysis showed that ABCD2 score ≥4 and FIB≥3.5 g/L were significantly associated with the composite endpoint. Conclusion The level of plasma FIB significantly increase in TIA patients with positive composite endpoint, and is posi- tively correlated with ABCD2 score. Using the threshold value of 3.5 g/L for FIB, there was a trend toward FIB predicting outcome of these patients within 90 days after TIA.

关 键 词：短暂性脑缺血发作 纤维蛋白原 ABCD2评分 

分 类 号：R743.31[医药卫生—神经病学与精神病学]