摘要
目的研究探讨D-二聚体(D-D)、血浆纤维蛋白原(FIB)与急性缺血性卒中患者静脉溶栓疗效的关系。方法选择2015年1月-2017年1月在惠州市中心人民医院进行治疗的急性缺血性卒中患者120例为研究对象,对患者进行以阿替普酶为主的溶栓治疗,根据患者静脉溶栓治疗的结果将其分为进展期组、非进展期组,根据患者出院结局情况將其分为出院结局良好组、出院结局不良组,对各组患者住院第1天、住院第7天、出院时的D-D、FIB水平进行检测,并进行组间比较。采用Pearson相关性检验对D-D、FIB水平与患者溶栓疗效间的相关性进行分析探讨。结果①进展期患者在住院第1天、住院第7天、出院时的D-D、FIB水平值均高于非进展期组,组间比较差异有统计学意义(P<0.05)。②出院结局不良患者在住院第1天、住院第7天、出院时的D-D、FIB水平值均高于出院结局良好患者,组间比较差异有统计学意义(P<0.05)。③经Pearson相关性检验分析,患者D-D、FIB水平与患者的神经功能缺损评分(NIHSS)、Rankin量表评分(mRS)呈正相关(P<0.05)。结论急性缺血性卒中患者的D-二聚体、血浆纤维蛋白原与患者的溶栓治疗效果及预后效果有关联性,当各项指标水平升高时提示患者的静脉溶栓治疗效果较差,并对患者出院结局有一定的预示作用,可为患者的疗效评估、出院结局等提供指导。
Objective To study the relationship between D-dimer(D-D),plasma fibrinogen(FIB)and intravenous thrombolysis in patients with acute ischemic stroke.Methods 120 patients with acute ischemic stroke who were treated in Huizhou Central People's Hospital from January 2015 to January 2017 were selected as the research subjects.The patients were treated with alteplase as the main thrombolytic therapy.According to the results of thrombolytic therapy,the patients were divided into progressive group and non-progressive group,and the patients were divided into good discharge outcomes group and poor discharge outcomes group according to their discharge outcomes.The levels of D-D and FIB at the first day of hospitalization,the seventh day of hospitalization,and the time of discharge were detected in the good group and the poor outcomes group.Pearson correlation test was used to analyze the correlation between D-D and FIB levels and thrombolytic efficacy.Results①The levels of D-D and FIB in prugressive patients on the first day of hospitalization,the seventh day of hospitalization and the time of discharge were higher than those in non-prugressive patients,and there was significant difference between the two groups(P<0.05).②The D-D and FIB levels of patients with poor discharge outcomes were higher than those of patients with good discharge outcomes on the first day,the seventh day and the time of discharge(P<O.05).③Pearson correlation test showed that D-D and FIB levels were positively correlated with NIHSS and Rankin scale(mRS)scores(P<0.05).Conclusions D-dimer and plasma fibrinogen in patients with acute ischemic stroke are associated with thrombolytic therapy and prognosis in patients.When the levels of various indicators are elevated,the effect of intravenous thrombolytic therapy is poor.It also has a certain predictive effect on the patient's discharge outcome,which can provide guidance for the patientzs efficacy evaluation and discharge outcome.
作者
陈东尔
黄晓东
曹开谊
CHEN Dong er;HUANG Xiao dong;CAO Kai yi(Department of Neurology,Huizhou Central People's Hospital,Huizhou Guangdong 516001,China)
出处
《中国急救复苏与灾害医学杂志》
2020年第1期51-53,94,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
急性缺血性卒中
D-二聚体
血浆纤维蛋白原
静脉溶栓
疗效关系
Acute ischemic stroke
D-dimer
Plasma fibrinogen
Intravenous thrombolysis
Curative effect relationship
