血浆 D-二聚体水平对急性脑梗死病情与预后判断的价值

摘要

Objective To explore the relationship between the plasma levels of D-dimer (DD) ,and the illness severity and infarct volume of acute cerebral infarction ,in order to clarify the value of plasma D-Dimer level for evaluating the state and prognosis of patients with acute cerebral infarction.Methods According to NIHSS points ,78 cases of patients with acute cere-bral infarction were divided into NIHSS ≤ 8 group and NIHSS> 8 group. Furthermore ,on the basis of infarct volume ,they were divided into large infarct volume(IV) group (≥10 cm3 ) ,medium IV group (4 cm3 < IV <10 cm3 ) and small IV group (≤4 cm3 ). The plasma D-Dimer levels were detected respectively on post-stroke 7d ,14 d and 28 d ,and the relationship be-tween D-Dimer levels and infarct volume and prognosis was analyzed.Results At each time point ,plasma D-Dimer levels of pa-tients with cerebral infarction were significantly higher than those of the control group (all of them P<0 .001). The D-Dimer levels in NIHSS> 8 group at each time point were greater than those of NIHSS ≤ 8 group (P<0.05). The differences of D-Dimer levels were large IV group >medium IV group> small IV group> control group (all of them P<0.01). There was a significant positive correlation between the plasma D-Dimer levels and infarct volume ,the NIHSS points ,NIHSS recovery in-dex.Conclusion Plasma D-Dimer levels may be a sensitive marker that can reflect the degree of disorders about endogenous co-agulation-fibrinolytic system and evaluate the state and prognosis of cerebral infarction.%目的：探索急性脑梗死患者血浆D-二聚体（D-D）水平与病情程度和梗死体积之间的关系，阐明其对急性脑梗死病情与预后判断的价值。方法根据NIHSS评分将78例急性脑梗死患者分为NIHSS≤8组和NIHSS＞8组，并根据梗死体积分为大梗死组（梗死体积≥10 cm3）、中梗死组（10 cm3＞梗死体积＞4 cm3）和小梗死组（梗死体积≤4 cm3），于发病7 d、14 d及28 d进行血浆D-D含量测定，分析D-D水平与病情、梗死体积和预后的相关性。结果脑梗死患者各时段血浆D-D水平均显著高于对照组（均 P＜0.001）。NIHSS＞8组各时段D-D含量均高于NIHSS≤8组（均 P＜0.05），大梗死组＞中梗死组＞小梗死组＞对照组，差异均有统计学意义（均 P＜0.01），血浆D-D含量与梗死体积、NIHSS积分和NIHSS恢复指数呈显著正相关。结论血浆D-D水平是反映内源性凝血纤溶系统紊乱程度、判断脑梗死病情和预后的敏感指标。