急性缺血性脑卒中患者血清D-二聚体、超敏C反应蛋白水平对溶栓后出血性转化的预测价值研究  

Predictive Value of Serum D-dimer and Hypersensitive C-reactive Protein Levels in Hemorrhagic Transformation after Thrombolysis in Patients with Acute Ischemic Stroke

作　　者：唐艳波 韩露 王文强 TANG Yanbo;HAN Lu;WANG Wenqiang(Emergency Department,Xinyi People's Hospital,Xinyi 221400,Jiangsu,China)

机构地区：[1]新沂市人民医院急诊科,江苏新沂221400

出　　处：《系统医学》2025年第5期63-66,共4页Systems Medicine

摘　　要：目的分析急性缺血性脑卒中(acute ischemic stroke,AIS)患者血清D-二聚体(d-dimer,D-D)、超敏C反应蛋白(hypersensitivity C-reactive protein,hs-CRP)水平对溶栓后出血性转化(hemorrhagic transformation,HT)的预测价值。方法回顾性选取2021年11月—2022年11月在新沂市人民医院接受溶栓治疗的86例AIS患者的临床资料,根据患者溶栓后是否HT分为HT组(31例)、非HT组(55例)。比较两组患者的临床资料及D-D、hs-CRP。使用Logistic回归分析溶栓后HT的危险因素。采用受试者工作特征曲线分析AIS溶栓后HT预测价值。结果观察组的溶栓后24 h的血清D-D、hs-CRP均高于对照组,差异有统计学意义(P均<0.05)。Logistic回归分析表明D-D、hs-CRP是HT的独立危险因素(P均<0.05)。D-D、hs-CRP联合检验预测AIS溶栓后HT曲线下面积为0.900,高于D-D、hs-CRP单一检测的0.826、0.788。结论血清D-D、hs-CRP联合检测对AIS患者溶栓后HT有较高预测价值。Objective To analyze the prediction value of serum d-dimer(D-D)and hypersensitivity C-reactive protein(hs-CRP)in patients with acute ischemic stroke(AIS)for hemorrhagic transformation(HT)after thrombolytic therapy.Methods The clinical data of eighty-six patients with AIS who received thrombolytic therapy in Xinyi People's Hospital from November 2021 to November 2022 were retrospectively selected.The patients were divided into HT group(thirty-one cases)and non-HT group(fifty-five cases)according to whether they were HT after thrombolytic therapy.The clinical data and serum D-D and hs-CRP levels were compared between the two groups.Logistic regression was used to analyze the risk factors of HT after thrombolysis.The predictive value of HT after AIS thrombolysis was analyzed by receiver operating characteristic curve.Results The serum D-D and hs-CRP levels in the observation group were higher than those in the control group 24 h after thrombolysis,and the differences were statistically significant(both P<0.05).Logistic regression analysis showed that D-D and hs-CRP were independent risk factors for HT(both P<0.05).The area under the HT curve predicted by combined test of D-D and hs-CRP after AIS thrombolysis was 0.900,higher than 0.826,0.788 of D-D,hs-CRP single test,respectively.Conclusion The combined detection of serum D-D and hs-CRP levels showed a high predictive value for HT after thrombolysis in AIS patients.

关 键 词：急性缺血性脑卒中 D-二聚体 超敏C反应蛋白 溶栓 出血性转化 

分 类 号：R4[医药卫生—临床医学]