溶栓前血糖、D-二聚体和纤维蛋白降解产物水平与老年急性脑梗死阿替普酶静脉溶栓治疗疗效和预后的相关性分析  

Correlation analysis between the levels of blood glucose,D-dimer and fibrin degradation products before thrombolysis and the efficacy and prognosis of intravenous thrombolysis with alteplase in elderly patients with acute cerebral infarction

作　　者：熊晶[1] 朱维芳[1] 梅蕊[2] Xiong Jing;Zhu Weifang;Mei Rui(Intravenous Drug Preparation Center,First Hospital of Wuhan City,Wuhan,Hubei,430030,P.R.China;Medical Administration Division,Mental Health Center of Wuhan City,Wuhan,Hubei,430030,P.R.China)

机构地区：[1]武汉市第一医院静配中心,湖北武汉430030 [2]武汉市精神卫生中心医务部,湖北武汉430030

出　　处：《老年医学与保健》2021年第4期772-775,共4页Geriatrics & Health Care

摘　　要：目的研究溶栓前血糖、纤维蛋白降解产物(FDP)、D-二聚体(D-D)水平与老年急性脑梗死(ACI)阿替普酶静脉溶栓治疗疗效和预后的相关性。方法选取2019年2月-2020年2月武汉市第一医院收治的87例老年ACI患者记为观察组(根据疗效和预后又分为有效亚组和无效亚组、预后良好亚组和预后不良亚组),同期在我院体检的健康者70例记为对照组,对比各比较组空腹血糖、D-D和FDP水平,对比不同疗效、预后的溶栓患者空腹血糖、D-D和FDP水平,通过spearman检验,分析空腹血糖、D-D和FDP与阿替普酶静脉溶栓治疗老年患者ACI的疗效和预后的相关性,通过受试者工作特征曲线(ROC),分析空腹血糖、D-D和FDP对老年ACI患者预后评估价值。结果与对照组进行比较,观察组空腹血糖、D-D和FDP水平明显上调(P<0.05);与有效亚组进行比较,无效亚组空腹血糖、D-D和FDP水平显著更高(P<0.05);与预后良好亚组进行比较,预后不良亚组空腹血糖、D-D和FDP水平明显增高(P<0.05);空腹血糖、D-D和FDP水平增高与老年ACI患者疗效和预后差均呈正相关(P<0.05);ROC显示,空腹血糖、D-D和FDP联合评估老年ACI患者预后的AUC是0.929,灵敏度是84.6%,特异度是88.6%。结论溶栓前空腹血糖、D-D和FDP联合检测对老年急性脑梗死患者阿替普酶静脉溶栓治疗疗效和预后有一定的评估价值。Objective To study the correlation of blood glucose,D-dimer(D-D)and fibrin degradation products(FDP)before thrombolysis with the efficacy and prognosis of intravenous thrombolysis with alteplase in elderly patients with acute cerebral infarction(ACI).Methods 87 elderly patients with ACI treated in the First Hospital of Wuhan City from February2019 to February 2020 were selected as the observation group(divided into effective subgroup and ineffective subgroup,good prognosis subgroup and poor prognosis subgroup according to curative effect and prognosis),and 70 healthy people who underwent physical examination in the hospital in the same period were selected as the control group.The levels of fasting blood glucose,D-D and FDP were compared between the comparative groups groups.The levels of above three indexes were also compared among the patients with different clinical outcomes and prognosis.Spearman test was used to analyze the correlation of fasting blood glucose,D-D and FDP with the efficacy and prognosis of alteplase intravenous thrombolysis in elderly patients with ACI.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of fasting glucose,D-D and FDP in elderly patients with ACI.Results The levels of fasting blood glucose,D-D and FDP of the observation group were significantly higher than those of the control group(P<0.05).The levels of fasting blood glucose,D-D and FDP of the ineffective subgroup were significantly higher than those of the effective subgroup(P<0.05).The levels of fasting blood glucose,D-D and FDP of the poor prognosis subgroup were significantly higher than those of the good prognosis group(P<0.05).The increase of fasting blood glucose,D-D and FDP levels were positively correlated with the poor curative effect and prognosis of elderly patients with ACI.ROC shows that the combined detection of fasting blood glucose,D-D and FDP predicted the prognosis of elderly ACI patients with an AUC of 0.929,a sensitivity of 84.6%,and a specificity of 88.6%,respective

关 键 词：老年 急性脑梗死 空腹血糖 纤维蛋白降解产物 D-二聚体 静脉溶栓 疗效 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]