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目的探讨对急性进展性脑梗死(APCI)患者检测炎症因子表达及凝血相关指标的临床意义。方法 48例APCI患者作为进展组,48例非进展性脑梗死患者作为非进展组,48例体检健康者作为健康组,应用免疫比浊法对三组白细胞介素-6(IL-6)、C反应蛋白(CRP)、前白蛋白(PA)等炎症因子表达水平进行检测,应用流式细胞仪、全自动血凝分析仪及蛋白分析仪对三组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fg)等凝血相关指标水平进行检测,并进行组间比较。结果进展组与非进展组IL-6水平分别为(128.3±21.5)、(78.5±6.9)pg/ml,均高于健康组的(34.3±4.1)pg/ml,差异均具有统计学意义(P<0.05);进展组与非进展组CRP水平分别为(11.4±2.1)、(6.2±1.3)mg/L,均高于健康组的(1.3±0.4)mg/L,差异均具有统计学意义(P<0.05);进展组与非进展组PA水平分别为(117.9±12.4)、(204.6±18.5)mg/L,均低于健康组的(236.8±24.3)mg/L,差异均具有统计学意义(P<0.05);且进展组IL-6、CRP水平均高于非进展组,PA水平低于非进展组,差异均具有统计学意义(P<0.05)。进展组TT为(10.1±1.3)s、PT为(9.1±1.4)s、Fg为(5.9±1.2)g/L、APTT为(28.5±2.6)s,健康组TT为(15.7±2.1)s、PT为(12.7±2.3)s、Fg为(2.7±0.5)g/L、APTT为(36.9±3.2)s,非进展组TT为(13.3±1.7)s、PT为(11.1±1.9)s、Fg为(3.5±0.8)g/L、APTT为(33.2±2.9)s;进展组TT、PT、APTT均低于健康组与非进展组,Fg高于健康组与非进展组,差异均具有统计学意义(P<0.05);健康组与非进展组TT、PT、Fg、APTT水平对比差异均无统计学意义(P>0.05)。结论炎症因子表达及凝血相关指标检测异常为APCI患者的危险因素,可作为主要参考依据监测脑梗死患者病程变化,并尽早行抗凝治疗,以改善预后。
Objective To investigate the clinical significance of detecting the expression of inflammatory cytokines and related indicators of coagulation in patients with acute progressive cerebral infarction (APCI). Methods Forty-eight patients with APCI as the progressing group, 48 patients with non-progressing cerebral infarction as the non-progressing group and 48 healthy people as the healthy group. The levels of interleukin-6 (IL-6), interleukin- C reactive protein (CRP), prealbumin (PA) and other inflammatory factors were detected by flow cytometry, automatic hemagglutination analyzer and protein analyzer on thrombin time (TT), prothrombin Time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg) and other coagulation-related indicators were detected and compared between groups. Results The levels of IL-6 in progression group and non-progression group were (128.3 ± 21.5) and (78.5 ± 6.9) pg / ml, respectively, which were significantly higher than those in healthy group (34.3 ± 4.1) pg / ml P <0.05). The CRP levels in the progression group and the non-progression group were (11.4 ± 2.1) and (6.2 ± 1.3) mg / L, respectively, which were significantly higher than those in the healthy group (1.3 ± 0.4) mg / (P <0.05). The levels of PA in the progression group and the non-progression group were (117.9 ± 12.4) and (204.6 ± 18.5) mg / L respectively, both lower than those in the healthy group (236.8 ± 24.3 mg / L) (P <0.05). The levels of IL-6 and CRP in the progression group were significantly higher than those in the non-progression group and PA group were lower than those in the non-progression group. The difference was statistically significant (P <0.05). The progression group TT was (10.1 ± 1.3) s, PT was (9.1 ± 1.4) s, Fg was (5.9 ± 1.2) g / L, APTT was (28.5 ± 2.6) s and TT was (15.7 ± 2.1) s , PT was (12.7 ± 2.3) s, Fg was (2.7 ± 0.5) g / L, APTT was (36.9 ± 3.2) s, TT was (13.3 ± 1.7) s in untreated group, PT was (11.1 ± 1.9) s , Fg was (3.5 ± 0.8) g / L and APTT was (33.2 ± 2.9) s respectively. The levels of TT, PT and APTT in progression group were lower than those in healthy group and non-progression group, (P <0.05). There was no significant difference in TT, PT, Fg and APTT between healthy group and non-progress group (P> 0.05). Conclusions Inflammatory cytokine expression and clotting-related index abnormalities are risk factors for APCI. It can be used as the main reference to monitor the course of disease in patients with cerebral infarction. Anticoagulation therapy can be used as soon as possible to improve the prognosis.