急性脑梗死患者血小板聚集率及凝血功能检测的临床意义  

Clinical significance of platelet aggregation rate and coagulation function in patients with acute cerebral infarction

作　　者：陈静静 沈继录[1,2] 丁玲 徐倩 宋胜兰 CHEN Jingjing;SHEN Jilu;DING Ling;XU Qian;SONG Shenglan(Department of Clinical Laboratory,the First Affiliated Hospital of Anhui Medical University,Hefei.230000,China;Anhui Public Health Clinical Center)

机构地区：[1]安徽医科大学第一附属医院检验科,合肥230000 [2]安徽省公共卫生临床中心

出　　处：《临床血液学杂志》2025年第2期96-100,共5页Journal of Clinical Hematology

基　　金：安徽医科大学校科研基金(No:2019xkj159)。

摘　　要：目的:检测并分析急性脑梗死患者血小板聚集率及凝血功能相关指标,探讨这些指标在急性脑梗死患者中的临床价值。方法:选取2023年2月—2024年6月安徽医科大学第一附属医院收治的105例脑梗死患者为试验组,根据病情分为急性脑梗死组(65例)与非急性脑梗死组(40例),同时选择同期40例健康体检者为对照组,测定并分析比较急性脑梗死组、非急性脑梗死组和对照组的花生四烯酸血小板最大聚集率(AA-MAR)、二磷酸腺苷血小板最大聚集率(ADP-MAR)及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-D),采用Spearman相关分析急性脑梗死组的PT、APTT、FIB、TT、D-D与AA-MAR、ADP-MAR的相关性以及与神经功能缺损程度的关系。应用ROC曲线来判断FIB、D-D、AA-MAR和ADP-MAR指标对急性脑梗死的诊断效能。结果:与非急性脑梗死组比较,急性脑梗死组的D-D、AA-MAR和ADP-MAR均明显增高,差异有统计学意义(P<0.05)。通过Spearman相关分析,结果表明急性脑梗死患者D-D、FIB与AA-MAR和ADP-MAR呈正相关(P<0.05)。与神经功能缺损的轻度和中度组比较,重度组的D-D、AA-MAR和ADP-MAR明显增加。ROC曲线分析显示D-D、ADP-MAR和AA-MAR曲线下面积(AUC)分别为0.971、0.899和0.816,差异有统计学意义(P<0.05)。结论:急性脑梗死患者的血小板聚集率及凝血功能相关指标的检测在临床急性脑梗死的诊断,血栓的早期预测以及病情严重程度的判断中具有重要临床参考价值。Objective:To investigate the clinical value of platelet aggregation rate and coagulation function in patients with acute cerebral infarction.Methods:A total of 105 patients with cerebral infarction admitted to the First Affiliated Hospital of Anhui Medical University from February 2023 to June 2024 were selected as experimental group in this study,and the experimental group was divided into acute cerebral infarction group and non-acute cerebral infarction group.At the same time,40 healthy physical examination subjects in the same period were selected as the control group.Maximum aggregation rate of arachidonic acid platelets(AA-MAR)and maximum aggregation rate of platelets(ADP-MAR)and prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-dimer(D-D)were measured and compared among acute cerebral infarction group,non-acute cerebral infarction group and the control group.Spearman correlation analysis was used to analyze the correlation between PT,APTT.FIB.TT,DD with AA-MAR and ADP-MAR,and their relationship with the degree of neurological deficits were also analyzed.ROC curve was used to evaluate the diagnostic efficacy of FIB,D-D,AA-MAR and ADP-MAR in the patients with acute cerebral infarction.Results:FIB,D-D.AA-MAR and ADP-MAR in the acute cerebral infarction group were significantly higher than those in control group.D-D,AA-MAR and ADP-MAR in the acute cerebral infarction group were significantly higher than those in non-acute cerebral infarction group.Spearman correlation analysis showed that D-D and FIB were posi-tively correlated with AA-MAR and ADP-MAR(P<O.O5).ROC curve showed that the areas under the curves were 0.971、0.899 and 0.816 for D-D,ADP-MAR and AA-MAR between acute cerebral infarction group and nonacute cerebral infarction group,respectively(P<o.05).Conclusion:The detection of platelet aggregation rate and coagulation function in the patients with acute cerebral infarction may have important clinical value in the diagnosis of acute cerebral infarctio

关 键 词：急性脑梗死 凝血功能 血小板最大聚集率 D-二聚体 

分 类 号：R446.11[医药卫生—诊断学]