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目的:探讨老年短暂性脑缺血发作(TIA)与C反应蛋白(CRP)和血浆D-二聚体(D-dimer,D-D)的关系。方法:将我院2008年6月—2010年2月收治的92例高海拔地区老年TIA患者按病程划分为3组:TIA持续60分内缓解为A组(35例);TIA超过60分,并反复发作,但无持久的神经损害症状,无脑梗死发生者为B组(31例);以TIA起病,以后发展为脑梗死为C组(26例)。所有病例在起病24小时内检测血清CRP和D-二聚体质量浓度,观察72小时内头颅CT或MRI,将结果与正常对照组28例进行组间比较。结果:TIA患者血清CRP和D-二聚体的质量浓度高于对照组(P<0.01),B、C组均高于A组(P<0.01),且C组高于B组(P<0.05),TIA各组CRP和D-二聚体质量浓度呈正相关。结论:①CRP是D-D升高的主要相关因素;②CRP和D-D的升高是高海拔地区老年TIA患者的危险因素;③CRP和D-D的升高可以对高海拔地区老年TIA患者的诊断、治疗和估计预后提供较可靠的实验室指标。
Objective: To investigate the relationship between TIA and C-reactive protein (CRP) and plasma D-dimer (D-D) in elderly patients with transient ischemic attack. Methods: A total of 92 high-altitude elderly patients with TIA admitted to our hospital from June 2008 to February 2010 were divided into 3 groups according to their duration of disease: TIA was relieved within 60 minutes in group A (35 cases); TIA exceeded 60 points, And recurrent, but no lasting symptoms of nerve damage, no cerebral infarction occurred in group B (31 cases); TIA onset, later developed into cerebral infarction group C (26 cases). Serum CRP and D-dimer concentrations were measured in all cases within 24 hours of onset, and CT or MRI was observed within 72 hours. The results were compared with the normal control group of 28 cases. Results: The serum concentrations of CRP and D-dimer in TIA patients were significantly higher than those in control group (P <0.01), and those in B and C groups were significantly higher than those in A and C groups (P < 0.05). There was a positive correlation between CRP and D-dimer concentrations in TIA groups. Conclusion: (1) CRP is the main factor related to the increase of DD; (2) elevated CRP and DD are risk factors for elderly TIA in high altitude areas; (3) elevated CRP and DD may improve the diagnosis, treatment and prognosis of elderly TIA in high altitude areas Provide more reliable laboratory indicators.