不同卒中亚型脑梗死病人早期血浆D-二聚体水平与急性期神经功能改善及预后的相关性  

Correlation of D-dimer Contents at Acute Stage with the Neurological Function Improvement and Prognosis in Patients with Different Stroke Subtypes of Cerebral Infarction

作　　者：于小琪[1] 秦琴保[1] 王双艳[1] 李晴[1] 王敏健[1] Yu Xiaoqi;Qin Qinbao;Wang Shuangyan;Li Qing;Wang Minjian(Guangzhou First People＇s Hospital,Guangzhou 510180,Guangdong,China)

机构地区：[1]广州市第一人民医院,广州510180

出　　处：《中西医结合心脑血管病杂志》2018年第12期1762-1764,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨不同卒中亚型脑梗死病人早期血浆D-二聚体水平及其与急性期神经功能改善及预后的相关性。方法以2014年1月—2016年6月我院神经内科收治的167例脑梗死病人为研究对象。按照TOAST标准对病人进行分型,比较不同亚型病人间血浆D-二聚体水平;对比入院时与入院10 d后不同亚型间神经功能缺损改善情况及不同亚型病人间的死亡率。结果各亚型脑梗死病人间D-二聚体水平比较差异有统计学意义(P<0.05);多重比较结果显示,心源性脑栓死(CE)组血浆D-二聚体水平最高,其次为大动脉粥样硬化性脑卒中(LAA)组,不明原因的缺血性脑卒中(SUE)组次之,小动脉闭塞性脑卒中(SAO)组最低,但与SUE组比较差异无统计学意义(P>0.05),其他原因所致的缺血性卒中(SOE)组1例(未列入统计分析内);各亚型病人入院时神经功能缺损情况存在有统计学意义(P<0.05),以CE组缺损最为严重,SAO组程度最轻;入院10 d后各组神经功能缺损均有所改善,差异有统计学意义(P<0.05),CE组最低,SAO组改善程度最高。急性期以CE组(34.1%)的死亡率最高,其次为LAA组(6.3%),SAO组在急性期未观察到死亡病例,CE组死亡率显著高于其他各组(P<0.05),其余各组间差异无统计学意义。结论不同卒中亚型的脑梗死病人早期血浆D-二聚体水平存在统计学意义,血浆D-二聚体水平可作为此类病人预后评估的参考依据。Objective To study the correlation of D-dimer contents at acute stage with the neurological function improvement and prognosis in patients with different stroke subtypes of cerebral infarction.Methods One hundred and sixty-seven patients with cerebral infarction in department of neurology from January 2014 to June 2016 were selected.According to TOAST,the D-dimer contents were compared among patients with different stroke subtype.The neurologic function improvement and death rate for patients with different stroke subtypes were compared between admission of hospital and after 10d of admission.Results There were significant differences in D-dimer levels between patients with subtypes of cerebral infarction（ P〈0.05）.The results of multiple comparisons showed that the plasma D-dimer level was the highest in the CE group,followed by LAA group,SUE group and SAO group,but there was no statistical significance compared with the SUE group（ P〉0.05）.There was one case in SOE group.The neurological deficits of all subtypes were statistically significant（ P〈0.05）.The neurologic impairment was the most severely deficient in CE group,and the least severe in SAO group.After 10 days of admission,the neurological deficits of each group were improved.The neurologic function improvement was lowest in CE group,and highest in SAO group.The death rate in CE group was highest（ 34.1%）,followed by LAA group（ 6.3%） at acute stage.There was no death case in SAO group.The mortality in CE group was significantly higher than that of other groups（ P〈0.05）.Conclusion The plasma D-dimer levels in patients with cerebral infarction of different stroke subtypes were statistically significant.The D-dimer contents are correlated with the improvement of neurological function.Therefore,plasma D-dimer level can be used as a reference for prognosis.

关 键 词：脑梗死 卒中亚型 血浆D-二聚体 神经功能 预后 相关性 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]