血浆 D-二聚体和纤维蛋白原降解产物在急性脑梗死患者中的检测意义

摘要

目的：分析血浆D-二聚体（ DD）和纤维蛋白原降解产物（ FDP）水平检测在急性脑梗死患者中的临床意义。方法：93例临床确诊的急性脑梗死患者（急性脑梗死组）于入院24 h、3 d、7 d抽取空腹静脉血，分别采用ELISA法和Clause法测定DD和FDP水平。选择同期45例健康体检者作为对照（对照组）。结果：急性脑梗死组24 h、3 d DD水平显著高于对照组（ P＜0．01、P＜0．05），7 d时较对照组无显著差异（P＞0．05）。急性脑梗死组24 h FDP与对照组比较无显著变化（P＞0．05），3 d及7 d时FDP水平显著高于对照组（ P＜0．01、P＜0．05）。中、重型组DD、FDP水平分别显著高于轻型组（ P＜0．05、P＜0．01），而重型组DD、FDP水平显著高于中型组（ P＜0．05）。中梗死灶、大梗死灶DD、FDP水平分别显著高于小梗死灶（P＜0．05、P＜0．01），而大梗死灶DD、FDP 水平显著高于中梗死灶（P＜0．05）。急性脑梗死患者DD水平与FDP水平呈显著正相关（r＝0．71，P＜0．05）。结论：急性脑梗死患者血浆DD和FDP水平呈不同程度的增高，动态监测患者血浆DD和FDP水平对于判断脑梗死的严重程度和梗死病灶大小具有重要临床意义。%Objective:To analyze the clinical significance of determining plasma D-dimer ( DD) and fibrinogen degradation products ( FDP) in patients with acute cerebral infarction.Methods: A total of 93 patients with acute cerebral infarction ( acute cerebral infarction group ) were collected fasting venous blood 24 hours, 3 days and 7 days after admitted in hospital, and ELISA and Clause assay were used to determine DD and FDP levels.45 healthy examines were selected as controls (control group).Results:The DD level at 24 hours and 3 days of acute cerebral infarction group was statistically higher than that of control group ( P<0.01, P<0.05), but the DD level at 7 days had no statistical difference compared with the control group ( P>0.05).The FDP level at 24 hours of acute cerebral infarction group showed no difference compared with control group (P>0.05), but the FDP level at 3 days and 7 days was significantly higher than that of control group (P<0.01, P<0.05).The DD and FDP levels of moderate and severe group were obviously higher than those of mild group (P<0.05, P<0.01), and the DD and FDP levels of severe group were higher than those of moderate group ( P<0 .05 ) .The DD FDP levels of median and large size infarct were statistically higher than those of small size infarct (P<0.05, P<0.01), and the DD FDP levels of large size infarct were obviously higher than those of median size infarct ( P<0 .05 ) .The DD level of acute cerebral infarction was positively correlated with FDP level (r=0.71, P<0.05).Conclusion:The plasma DD and FDP level of pa-tients with acute cerebral infarction are increased at different degrees, monitoring the plasma DD and FDP level is important for judging the severity of cerebral infarction and size of infarct.