血浆D-二聚体和超敏C反应蛋白检测在急性脑梗死中的临床价值

血浆D-二聚体和超敏C反应蛋白检测在急性脑梗死中的临床价值

孟颖，冯敏，谢康，郑重

(蚌埠医学院第二附属医院神经内科，安徽 蚌埠 233004)

摘要：目的探讨血浆D-二聚体(D-dimer，D-D)及超敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)水平与急性脑梗死(acute cerebral infarct，ACI)的关系。方法采用免疫透射比浊法检测102例ACI患者和50例正常对照者血浆D-D和hs-CRP水平。根据梗死灶大小102例ACI患者分为大梗死灶组、中梗死灶组和小梗死灶组，并进行相关统计分析。结果ACI组患者血浆D-D和hs-CRP水平显著高于正常对照组(P<0.01)；大梗死灶组D-D和hs-CRP水平明显高于中、小梗死灶，而中梗死灶组D-D和hs-CRP水平高于小梗死灶组。结论监测血浆D-D和hs-CRP能为ACI的临床诊断、病情判断提供重要的参考依据。

关键词：急性脑梗死；血浆D-二聚体；超敏C反应蛋白

中图分类号：R 743.33

The Clinical Value of the Plasma D-dimer and High-sensitivity C-reactive

Protein Detection Monitoring in Acute Cerebral Infarction

MENG Ying,FENG Min,XIE Kang,et al

(Department of Gastroenterology,The Second Affiliated Hospital,Bengbu Medical College,Bengbu 233004,China)

Abstract:ObjectiveTo investigate the relationship between the levels of plasma D-dimer and serum high-sensitivity C-reactive protein in patients with acute cerebral infarction.MethodsTo assay plasma D-D and hs-CRP levels in 102 patients with ACI and 50 cases in normal control group by the immunoturbidimetric method and divide them into large infarction group,medium infarction group and small infarction group according to the size of infarction,then analyze the related statistics.ResultsThe plasma D-D and hs-CRP levels of ACI patients are significantly higher than those in normal control group(P<0.01),the levels of plasma D-D and hs-CRP in large infarction group are obviously higher than those of small and medium-sized infarctions and the levels of the medium-sized infarction are higher than those of the small infarction.ConclusionThe determination of plasma D-D and hs-CRP can provide important reference value for clinical diagnosis and severity of ACI judgment.

Key words:acute cerebral infarction;D-dimer;sensitivity C-reactive protein

急性脑梗死(acute cerebral infarct，ACI)是临床常见病，是目前导致患者长期致残的主要病因之一，该病具有发病率高和病死率高等特点，已经引起人们高度重视。近年来，有研究显示D-二聚体(D-dimer，D-D)及超敏C反应蛋白(high-sensitivity C-reactive protein，hs-CRP)与ACI发病密切相关，D-D是交联纤维蛋白水解后所产生一种特异性降解产物，在凝血、纤溶系统的平衡调节中起重要作用，可作为反映血液高凝状态和纤溶亢进分子标志物之一[1-2]；hs-CRP作为机体炎性反应的生物学标志，也是参与动脉硬化的重要炎性因子。本研究旨在探讨血浆D-D和hs-CRP与ACI的关系。

1资料与方法

1.1　一般资料

选取蚌埠医学院第二附属医院神经内科2014-01—12月住院ACI患者102例，其中男57例，年龄32~76岁，平均年龄51岁；女45例，年龄37~74岁，平均年龄57岁。脑梗死诊断符合全国第四届脑血管病会议制定的诊断标准，均经头颅CT、头颅MRI证实，发病24 h内入院治疗。梗死灶体积按Pullitono公式计算，梗死灶体积(cm3)=长径×短径×梗死面数/2，小梗死灶组39例(梗死体积<5 cm3)；中梗死灶组35例(梗死体积5～10 cm3)；大梗死灶组28例(梗死体积>10 cm3)。……