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目的探讨不同亚型急性缺血性脑卒中患者血浆D-二聚体含量的变化及其意义。方法 107例急性缺血性脑卒中患者按照TOAST标准进行病因学分型,大动脉粥样硬化性脑卒中(large-artery athero-sclerosis,LAA),小动脉闭塞性脑卒中或腔隙性脑卒中(small artery occlusion,SAO),心源性脑栓塞(cardio-embolism,CE),其他确定原因引起的缺血性脑卒中(stroke of other demonstrated etiology,SOE)和不明原因的缺血性脑卒中(stroke of undemomtrated etiology,SUE)。用酶联免疫吸附试验检测急性缺血性脑卒中患者发病后1、7和14d时血浆D-二聚体含量,并与65例对照者进行比较。结果在急性缺血性脑卒中亚型组血浆D-二聚体含量显著高于对照组(P<0.05);在急性期(第1d)增高,在高峰期(第7d)较急性期明显增高,在恢复期(第14d)下降至急性期水平,仍明显高于正常值;在急性缺血性脑卒中组中CE组血浆D-二聚体含量最高,显著高于其他各亚型组(P<0.05);LAA组血浆D-二聚体含量也显著高于SAO组、SUE组和SOE组(P<0.05).结论在急性缺血性脑卒中血浆D-二聚体含量升高明显,不同亚型的升高程度不同,这对于临床早期分型诊断并及时给予相应治疗具有重要意义。
Objective To investigate the changes of plasma D-dimer levels in patients with different subtypes of acute ischemic stroke and its significance. Methods A total of 107 patients with acute ischemic stroke were enrolled in this study according to TOAST criteria for etiological classification, large-artery athero-sclerosis (LAA), arteriolar occlusive stroke or lacunar stroke arterial occlusion (SAO), cardio-embolism (CE), stroke of other advanced etiology (SOE) and stroke of other causes of ischemic stroke undemomtrated etiology, SUE). Plasma D-dimer levels at 1, 7 and 14 days after onset of acute ischemic stroke were measured by enzyme-linked immunosorbent assay and compared with 65 controls. Results The level of plasma D-dimer in acute ischemic stroke subgroup was significantly higher than that in control group (P <0.05), increased in acute phase (1st day), and significantly increased in peak period (7th day) compared with acute phase , And it was still significantly higher than the normal value in the recovery phase (14d), but the plasma D-dimer was the highest in CE group in acute ischemic stroke group, which was significantly higher than that in other subtypes P <0.05). The plasma D-dimer level in LAA group was also significantly higher than that in SAO group, SUE group and SOE group (P <0.05) .Conclusion The plasma D-dimer levels in acute ischemic stroke were significantly increased , Different subtypes of different levels of elevation, which for the early diagnosis of clinical classification and timely treatment is of great significance.