D-二聚体、纤维蛋白原评估大脑动脉粥样硬化型缺血性脑卒中斑块易损性的价值  

The value of D-dimer and fibrinogen in assessing the vulnerability of carotid plaque of cerebral atherosclerosis stroke

作　　者：林秀慧 王逸如 吴旭杰 吴志敏[1] 赵娜[1] LIN Xiu-hui;WANG Yi-ru;WU Xu-jie;WU Zhi-min;ZHAO Na(Wenzhou TCM Hospital of Zhejiang Chinese Medical University,Wenzhou,Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院,浙江温州325000

出　　处：《中国卫生检验杂志》2023年第21期2610-2613,共4页Chinese Journal of Health Laboratory Technology

基　　金：温州市科技局项目(Y20220227)。

摘　　要：目的探讨D-二聚体(D-D)、纤维蛋白原(FIB)评估大脑动脉粥样硬化型(LAA)缺血性脑卒中斑块易损性的价值。方法选择2020年4月-2022年12月本院收治的179例LAA脑卒中患者作为研究对象,根据颈动脉血管超声结果将患者分为易损斑块组和稳定斑块组,比较2组患者临床资料;采用logistic回归分析影响斑块易损性的因素;采用ROC曲线分析D-D、FIB预测斑块易损性的价值,采用Pearson相关性分析D-D、FIB与三维超声参数灰阶中位数(CSM)的关系。结果易损斑块组患者男性比例、吸烟比例、D-D水平、FIB水平、Hcy水平高于稳定斑块组(P<0.05);logistic回归分析显示,吸烟史、D-D、FIB是影响LAA斑块易损性的主要因素(P<0.05),性别、Hcy与斑块易损性无显著相关性(P>0.05);D-D、FIB评估斑块易损性的AUC分别为0.731、0.729;LAA脑卒中患者D-D、FIB水平与三维超声参数CSM值成负相关(P<0.05)。结论D-D、FIB与LAA脑卒中斑块易损性关系密切,可作为评估斑块易损性的辅助指标。Objective This paper aims to investigate the value of D-dimer(D-D)and fibrinogen(FIB)in assessing the vulnerability of carotid plaque of large artery atherosclerosis(LAA)stroke.Methods A total of 179 patients with LAA stroke admitted to our hospital from April 2020 to December 2022 were selected as the study subjects.Patients were divided into vulnerable plaque group and stable plaque group according to carotid artery ultrasound results,and the clinical data of the two groups were compared.Logistic regression was used to analyze the influencing factors of plaque vulnerability.ROC curve was used to analyze the value of D-D and FIB in predicting the plaque vulnerability,and Pearson correlation was used to analyze the relationship between D-D and FIB and the gray-scale median(CSM).Results The ratio of males,smoking ratio,D-D level,FIB level and Hcy level in the vulnerable plaque group were higher than those in the stable plaque group(P<0.05).Logistic regression analysis showed that smoking history,D-D and FIB were the main factors affecting plaque vulnerability(P<0.05),while gender and Hcy had no significant correlation with plaque vulnerability(P>0.05).The AUC of D-D and FIB to assess plaque vulnerability were 0.731 and 0.729.The levels of D-D and FIB in LAA stroke patients were negatively correlated with the three-dimensional ultrasound parameter CSM value(P<0.05).Conclusion D-D and FIB are closely related to the plaque vulnerability and can be used as auxiliary indicators to evaluate plaque vulnerability.

关 键 词：缺血性脑卒中 大脑动脉粥样硬化型 斑块易损性 D-二聚体 纤维蛋白原 

分 类 号：R743[医药卫生—神经病学与精神病学]