急性脑梗死患者炎症因子、血凝状态的变化  

The changes of platelet function,coagulation and fibrinolysis,and inflammatory factors in acute cerebral infarction

作　　者：李舟文[1] 许云耀 申梅[1] 钟锋[1] 谢彦鹏[1] 

机构地区：[1]广东梅州嘉应学院医学院,514031 [2]中山大学附属第三医院粤东医院

出　　处：《卒中与神经疾病》2017年第5期427-430,435,共5页Stroke and Nervous Diseases

基　　金：梅州市医研类科技计划项目(2015B045)

摘　　要：目的探讨急性脑梗死患者血小板功能、凝血与纤溶功能及炎症因子的变化情况。方法采用血凝仪和全自动生化分析仪测定106例急性脑梗死患者APTT、FIB、D-二聚体、hs-CRP、IL-6、TNF-α、PAg T等指标水平,并与100名健康者进行对照。结果急性脑梗死组患者凝血功能中APTT值明显缩短,FIB值和D-二聚体值明显增大,炎症因子中IL-6值、hs-CRP和TNF-α值明显升高,PAg T值增大,与对照组比较均有明显差异(P<0.01)。重度脑梗死组与中度和轻度脑梗死组比较,中度脑梗死组与轻度脑梗死组比较,各项检查值均明显改变(P<0.05)。采用多联指标分析,四项检测指标联合和五联项检测指标联合进行急性脑梗死预测与诊断,其灵敏性(100%,97%)、特异性(98%,100%)、阳性预测值(98%,100%)和阴性预测值(100%,97%)较理想。结论检测APTT值、FIB值、D-二聚体值、IL-6值、hs-CRP、TNF-α值和PAg T值对急性脑梗死的诊断和预后判断有一定的临床意义。Objective To investigate the changes of platelet function,coagulation and fibrinolysis,and inflammatory factors in acute cerebral infarction. Methods 106 cases of acute cerebral infarction were measured by blood coagulation analyzer and automatic biochemical analyzer to find the Determination of acute cerebral infarction,APTT,FIB,D-dimer,hs-CRP,IL-6,TNF alpha,PAg T,etc. At the same time,the correlation analysis was carried with100 healthy subjects. Results The APTT value of coagulation function in acute cerebral infarction group was shortened obviously,and the results of FIB and D-two were obviously increased,in inflammatory factors,the IL-6,hs-CRP and TNF-alpha values increased significantly,and the PAg T value increased. Compared with the control group,the differences were statistically significant（ P〈0. 01）. The values were considerably changed,and the difference was statistically significant between mild to moderate and severe cerebral infarction group,moderate and mild cerebral infarction group（ P〈0. 05）. Analysis values of APTT,FIB values,D-dimer,IL-6 values,hs CRP,TNF alpha and PAg T were used to Predict and diagnose acute cerebral infarction,their sensitivities were 100%,100%,specificities were98%,98%,positive predictive values were 98%,98% and negative predictive values were 100%,97%. Conclusion It had certain clinical significance for the diagnosis and prognosis of cerebral infarction to detect the values of APTT,FIB,D-two,IL-6,hs-CRP,TNF alpha and PAg T,and the results could be referred by clinicians.

关 键 词：脑梗死 炎症因子 血凝状态 

分 类 号：R743.32[医药卫生—神经病学与精神病学]