目的:探讨血浆D-二聚体(D-D)、纤维蛋白原(Fb)和抗凝血酶Ⅲ(AT-Ⅲ)在脑梗死(CI)不同时期的变化及其临床意义.方法:根据临床特征,对260例CI患者进行分组,其中CI急性期组80例、进展期组41例、非进展期组65例、康复期组74例;90例体检健康者为正常对照组.采用SYSMEX CA7000血凝仪分别检测其血浆D-D、Fb和AT-Ⅲ水平.结果:CI急性期、进展期、非进展期患者D-D、Fb含量均明显高于正常对照组(P<0.01),AT-Ⅲ低于正常对照组(P<0.01);脑梗死组中,D-D与AT-Ⅲ呈负相关(P<0.01),D-D与Fb呈正相关(P<0.01),AT-Ⅲ与Fb无相关性.结论:CI患者D-D、Fb、AT-Ⅲ变化显著,D-D升高伴随AT-Ⅲ含量降低,提示D-D、Fb、AT-Ⅲ共同参与了梗死发生发展的病理生理过程,可作为CI临床危险分级和病情监测的指标.%Objective To investigate the differences and its clinical significance of D-dimer, fibrinogen and antithrombin Ⅲ between varied clinical periods of cerebral infarction( CI). Methods 328 CI patients were rolled into the study, and they were divided into four groups due to their different clinical periods as follows: group acute period (80) , group progressing(41) , group non-pro-gressing(65) , group convalescence(74). And, 90 healthy volunteers were rolled into the normal control group. Their plasma D-dimer, fibrinogen and antithrombin HI were detected on SYSMEX CA7000 automatic coagulation analyzer. Results D-dimer and fibrinogen of CI patients in the acute, progressing and non-progressing periods were significantly higher (P <0.01) than those of healthy volunteers, while antithrombin Ⅲ of them was significantly lower (P<0.01) than that of healthy volunteers. In CI patients, D-dimer correlated negatively with antithrombin Ⅲ, while positively with fibrinogen. No significant relationship was observed between antithrombin Ⅲ and fibrinogen. ConclUSin D-dimer, fibrinogen and antithrombin Ⅲ of CI patients varied significantly and D-dimer elevate when antithrombin Ⅲ reduce, which indicated that D-dimer, fibrinogen and antithrombin Ⅲ might take part in the pathophysiolagical process of development of CI and be used to classification of risks and monitoring of patients' condition.
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