CAJ | 학술논문

背景:研究表明血浆中D-二聚体和纤维蛋白原与心脑血管疾病发生前的血凝状态密切相关.目的:分析老年心脑血管疾病患者及老年和中青年健康对照者血浆中血栓前状态分子标志物和纤维蛋白原水平差异.设计:以患者为观察对象,病例分析.单位:一所军区总医院的干部病房.对象:2000-10/2002-03解放军沈阳军区总医院第二干部病房收治的冠心病患者153例、脑血管疾病患者116例,年龄均60岁.另选择来本院体检的＜60岁健康者68例为中青年对照组,≥60岁健康者98例为老年对照组.方法:于入院后第2天取静脉血2 mL(服用阿司匹林者停药4 d采血),取血浆用法国Stago公司提供的STA-Compat全自动血凝仪和试剂盒,用免疫比浊法测定D-二聚体含量,用磁珠法测定纤维蛋白原含量.主要观察指标:观察各组D-二聚体和纤维蛋白原的含量.结果:参加试验的435例均进入结果分析.老年对照组的D-二聚体含量和纤维蛋白原含量[(0.91±0.51)mg/L,(3.69±1.25)g/L]高于中青年对照组[(0.48±0.15)mg/L,(3.12±0.76)g/L],t=2.39～2.66,P＜0.05.老年冠心病组,老年脑血管病组的D-二聚体含量[(1.35±0.72)mg/L,(1.16±0.98)mg/L]和纤维蛋白原含量[(4.16±1.30)mg/L,(4.05±1.98)g/L]显著高于老年对照组和中青年对照组,t=4.23～5.41,P＜0.01.结论:与中青年对照组比较,老年人群体内D-二聚体及纤维蛋白原水平升高,而心脑血管疾病组的D-二聚体及纤维蛋白原水平升高则更显著.
배경:연구표명혈장중D-이취체화섬유단백원여심뇌혈관질병발생전적혈응상태밀절상관.목적:분석노년심뇌혈관질병환자급노년화중청년건강대조자혈장중혈전전상태분자표지물화섬유단백원수평차이.설계:이환자위관찰대상,병례분석.단위:일소군구총의원적간부병방.대상:2000-10/2002-03해방군침양군구총의원제이간부병방수치적관심병환자153례、뇌혈관질병환자116례,년령균60세.령선택래본원체검적＜60세건강자68례위중청년대조조,≥60세건강자98례위노년대조조.방법:우입원후제2천취정맥혈2 mL(복용아사필림자정약4 d채혈),취혈장용법국Stago공사제공적STA-Compat전자동혈응의화시제합,용면역비탁법측정D-이취체함량,용자주법측정섬유단백원함량.주요관찰지표:관찰각조D-이취체화섬유단백원적함량.결과:삼가시험적435례균진입결과분석.노년대조조적D-이취체함량화섬유단백원함량[(0.91±0.51)mg/L,(3.69±1.25)g/L]고우중청년대조조[(0.48±0.15)mg/L,(3.12±0.76)g/L],t=2.39～2.66,P＜0.05.노년관심병조,노년뇌혈관병조적D-이취체함량[(1.35±0.72)mg/L,(1.16±0.98)mg/L]화섬유단백원함량[(4.16±1.30)mg/L,(4.05±1.98)g/L]현저고우노년대조조화중청년대조조,t=4.23～5.41,P＜0.01.결론:여중청년대조조비교,노년인군체내D-이취체급섬유단백원수평승고,이심뇌혈관질병조적D-이취체급섬유단백원수평승고칙경현저.
BACKGROUND: Some studies have revealed that plasma levels of D-dimer and fibrinogen are closely related to blood coagulation status before any occurrence of cardiovascular disease and cerebrovascular disease.OBJECTIVE: To investigate the difference in plasma levels of D-dimer and fibrinogen, two markers of prethrombosis, between elderly patients with cardiovascular or cerebral vascular disease and elderly and younger healthy persons.DESIGN: Case analysis based on patients.SETTING: Cadre ward of a military general hospital of Chinese PLA.PARTICIPANTS: From October 2000 to March 2002, 153 patients with cardiovascular disease and 116 patients with cerebral vascular disease, aging over 60 years, hospitalized in the Second Cadre Ward of the General Hospital of Shenyang Military Area Command of Chinese PLA were selected into this study. Meanwhile, healthy persons with normal results of physical examination conducted in this hospital were selected as controls. Of all the control persons,68 with an age less than 60 years were allocated into the younger control group and the other 98 persons were allocated into the elderly control group.METHODS: On the second day after hospitalization, a venous blood sample was taken from each patient. For those receiving medications of aspirin, their venous blood samples were taken on the 4th day after withdrawal. The plasmas of the samples were measured by using STA Compact, a fully automatic coagulation analyzer(Diagnostica Stago) and the auxiliary kit. The level of D-dimer was detected by employing the immunoturbidimetry assay(ITA) And the concentration of fibrinogen was measured by using the magnetic bead technologies.MAIN OUTCOME MEASURES: The plasma levels of D-dimer and fibrinogen were detected in each group.RESULTS: All the 435 participants entered the statistical analysis procedure. The plasma levels of D-dimer and fibrinogen of elderly control group [(0.91 ±0.51) mg/L and (3.69±1.25) g/L] were significantly higher than those of the younger control group[0.48 ± 0. 15) mg/L and(3.12±0.76) g/L] (t=2.39-2.66, P ＜ 0.05) .The plasma levels of D-dimer and fibrinogen of the elderly cardiovascular group [ (1.35 ± 0. 72) mg/L and(4. 16 ± 1.30) mg/L] and the elderly cerebral vascular group [(1.16±0.98) mg/L and(4.05±1.98) g/L]were significantly higher, as compared with the elder control group and the younger control group( t = 4.23-5.41, P ＜ 0.01 ).CONCLUSION: Compared to the younger control group, the plasma levels of D-dimer and fibrinogen of elderly population increase significantly, especially in those with cardiovascular disease or cerebral vascular disease.