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目的 :动态检测脑脊液Ferritin与D dimer含量 ,探讨在SAH诊断及病情观察中的作用。方法 :脑脊液Ferritin与D dimer含量测定分别应用放射免疫分析法及单抗ELLSA双抗体夹心法。观察SAH组和对照组以及SAH不同病情及发病时间Ferritin和D dimer含量。结果 :53例SAH脑脊液Ferritin与D dimer含量在 1月内均显著增高 ,分别在 3d内及 8～ 15d时含量最高 ,且其水平与SAH病情程度一致。与同时期的CT、MRI结果比较 ,脑脊液Ferritin与D dimer含量对SAH病后 1月内诊断阳性率为 10 0 % ;而急性期CT阳性率为 85 2 % ,半月后失去诊断价值 ;MRI在急性期无作用 ,亚急性期后阳性率 88 9%。在SAH出血量少或距SAH发病时间长 ,CT扫描阴性时 ,尤其是在病后 8～ 15d时 ,脑脊液Ferritin与D dimer含量显著增高。结论 :脑脊液Ferritin与D dimer含量测定在SAH诊断与鉴别诊断中是一项敏感、可靠的指标 ,对SAH病情观察及预后评估有一定参考价值。
Objective: To dynamically detect the content of Ferritin and D dimer in cerebrospinal fluid and to explore the role in the diagnosis and observation of SAH. Methods: Ferritin and D dimer levels in cerebrospinal fluid were detected by radioimmunoassay and monoclonal antibody ELLSA double antibody sandwich method respectively. The levels of Ferritin and D dimer in SAH group and control group as well as different SAH status and onset time were observed. Results: The levels of Ferritin and D dimer in 53 cases of SAH cerebrospinal fluid were all significantly increased in 1 month, which were highest in 3d and 8-15 days, respectively, and their levels were consistent with those of SAH. Compared with the results of CT and MRI in the same period, the positive rate of Ferritin and D dimer in cerebrospinal fluid in one month after SAH was 100%, while the positive rate of CT in acute phase was 85.2%, which lost the diagnostic value after half a month. Acute phase no effect, the subacute positive rate of 88 9%. Ferritin and D dimer levels in cerebrospinal fluid were significantly higher in patients with less bleeding from SAH, longer time to onset of SAH, negative CT scan, especially 8 to 15 days after disease. Conclusion: The determination of Ferritin and D dimer levels in cerebrospinal fluid is a sensitive and reliable indicator in the diagnosis and differential diagnosis of SAH. It may provide a reference value for the observation and prognosis evaluation of SAH.