目的：探究血浆大内皮素1（big ET-1）、D-二聚体及血清脂蛋白-a〔Lp（a）〕水平对急性缺血性脑卒中（ AIS）的预测价值。方法选取重庆市北部新区第一人民医院2011年1月—2014年1月收治的AIS患者68例作为卒中组，再按不同梗死面积分为两亚组，即腔隙性组29例（梗死灶横断面最大径﹤1.5 cm）和非腔隙性组39例（梗死灶横断面最大径≥1.5 cm）；选取同期在本院体检健康者68例为对照组。卒中组患者于入院次日、对照组受试者于体检当日清晨抽取空腹肘静脉血2 ml，离心后分别检测血浆big ET-1、D-二聚体水平、C反应蛋白（ CRP）、纤维蛋白原（FIB）水平、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、国际标准化比值（INR）、血清Lp（a）水平，并进行比较。结果卒中组患者血浆big ET-1、D-二聚体、CRP、FIB水平，血清Lp（ a）水平均高于对照组，APTT长于对照组（P﹤0.05）；两组受试者PT、INR比较，差异无统计学意义（P﹥0.05）。非腔隙性组患者血浆big ET-1、D-二聚体及血清Lp（a）水平高于腔隙性组（P﹤0.05）。结论血浆big ET-1、D-二聚体及血清Lp （ a）水平对AIS有一定的预测价值，可用于评估AIS患者梗死面积。%Objective To investigate the predictive value of plasma big endothelin-1,D-dimer levels and serum lipoprotein( a) level on acute ischemic stroke. Methods A total of 68 patients with acute ischemic stroke were selected as case group in the First People's Hospital of Xinbei District of Chongqing from January 2011 to January 2014,and a total of 68 healthy cases were selected as control group at the same time. According to the infarction areas, patients of case group were divided into subgroups A ( with the maximum diameter of infarction areas ﹤1. 5 cm, n =29 ) and B ( with the maximum diameter of infarction areas≥1. 5 cm,n=39). Plasma big endothelin-1,D-dimer,CRP,FIB levels,serum lipoprotein (a)level,APTT,PT and INR were detected and compared. Results Plasma big endothelin -1,D -dimer,CRP,FIB levels and serum lipoprotein( a) level of case group were statistically significantly higher than those of control group,APTT of case group was statistically significantly longer than that of control group(P﹤0. 05);no statistically significant differences of PT or INR were found between the two groups(P﹥0. 05). Plasma big endothelin-1,D-dimer levels and serum lipoprotein(a) level of B subgroup were statistically significantly higher than those of A subgroup ( P ﹤0. 05 ). Conclusion Plasma big endothelin-1,D-dimmer levels and serum lipoprotein(a)level have some predictive value on acute ischemic stroke,can be used in evaluating the infarction areas.
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