中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
14期
15-17
,共3页
纤维蛋白原%脑梗死%TOAST 病因学分型
纖維蛋白原%腦梗死%TOAST 病因學分型
섬유단백원%뇌경사%TOAST 병인학분형
Fibrinogen%Cerebral infraction%TOAST etiology classification
目的：探究纤维蛋白原（Fib）在急性脑梗死 TOAST 分型[大动脉粥样硬化（LAA）型和小动脉闭塞（SAO）型]中的水平变化及诊断价值。方法选择2012年6月至2013年6月住院的首次发病24 h 内的急性脑梗死患者117例及同期在门诊体检的正常健康者40例。所有患者于入院后1 h 内完善 Fib 水平测定及 NIHSS 评分，然后完善影像学、超声学及其他实验室检查。结果 LAA、SAO 两亚型及正常健康组 Fib 水平分别为（3.51±0.74）、（3.00±0.73）、（2.53±0.16）g/ L。LAA、SAO 两亚型 Fib 水平均较正常健康组高，LAA 型水平最高，两组间比较差异有统计学意义（P <0.05）；LAA、SAO 两亚型 NIHSS 分值分别为7.29±5.29和3.13±1.13，LAA 型高于SAO 型，两型间比较差异有统计学意义（P =0.035）；Fib 水平与 NIHSS 分值呈正相关（r =0.639，P =0.013）。回归方程为 NIHSS =-5.224+3.646Fib；ROC 曲线确立 Fib≥3.00 g/ L 判断为 LAA 型的灵敏度为60.1%，特异度为73.4%，阳性预测值为81.8%，阴性预测值为43.5%。结论 Fib 水平可协助急性脑梗死的早期病因学分型，尤其对 LAA 型的预测有一定的诊断价值。同时可在一定程度上反映脑梗死的严重程度。
目的：探究纖維蛋白原（Fib）在急性腦梗死 TOAST 分型[大動脈粥樣硬化（LAA）型和小動脈閉塞（SAO）型]中的水平變化及診斷價值。方法選擇2012年6月至2013年6月住院的首次髮病24 h 內的急性腦梗死患者117例及同期在門診體檢的正常健康者40例。所有患者于入院後1 h 內完善 Fib 水平測定及 NIHSS 評分，然後完善影像學、超聲學及其他實驗室檢查。結果 LAA、SAO 兩亞型及正常健康組 Fib 水平分彆為（3.51±0.74）、（3.00±0.73）、（2.53±0.16）g/ L。LAA、SAO 兩亞型 Fib 水平均較正常健康組高，LAA 型水平最高，兩組間比較差異有統計學意義（P <0.05）；LAA、SAO 兩亞型 NIHSS 分值分彆為7.29±5.29和3.13±1.13，LAA 型高于SAO 型，兩型間比較差異有統計學意義（P =0.035）；Fib 水平與 NIHSS 分值呈正相關（r =0.639，P =0.013）。迴歸方程為 NIHSS =-5.224+3.646Fib；ROC 麯線確立 Fib≥3.00 g/ L 判斷為 LAA 型的靈敏度為60.1%，特異度為73.4%，暘性預測值為81.8%，陰性預測值為43.5%。結論 Fib 水平可協助急性腦梗死的早期病因學分型，尤其對 LAA 型的預測有一定的診斷價值。同時可在一定程度上反映腦梗死的嚴重程度。
목적：탐구섬유단백원（Fib）재급성뇌경사 TOAST 분형[대동맥죽양경화（LAA）형화소동맥폐새（SAO）형]중적수평변화급진단개치。방법선택2012년6월지2013년6월주원적수차발병24 h 내적급성뇌경사환자117례급동기재문진체검적정상건강자40례。소유환자우입원후1 h 내완선 Fib 수평측정급 NIHSS 평분，연후완선영상학、초성학급기타실험실검사。결과 LAA、SAO 량아형급정상건강조 Fib 수평분별위（3.51±0.74）、（3.00±0.73）、（2.53±0.16）g/ L。LAA、SAO 량아형 Fib 수평균교정상건강조고，LAA 형수평최고，량조간비교차이유통계학의의（P <0.05）；LAA、SAO 량아형 NIHSS 분치분별위7.29±5.29화3.13±1.13，LAA 형고우SAO 형，량형간비교차이유통계학의의（P =0.035）；Fib 수평여 NIHSS 분치정정상관（r =0.639，P =0.013）。회귀방정위 NIHSS =-5.224+3.646Fib；ROC 곡선학립 Fib≥3.00 g/ L 판단위 LAA 형적령민도위60.1%，특이도위73.4%，양성예측치위81.8%，음성예측치위43.5%。결론 Fib 수평가협조급성뇌경사적조기병인학분형，우기대 LAA 형적예측유일정적진단개치。동시가재일정정도상반영뇌경사적엄중정도。
Objective To investigate the levels changes and diagnostic value of fibrinogen in the TOAST etiology classification of acute cerebral infarction[ large-artery atherosclerosis( LAA)and small-artery occlusion(SAO)]. Methods From June 2012 to June 2013,117 patients with acute cere-bral infraction within 24 h after the first onset of symptoms and 40 healthy controls were chose. The plas-ma concentration of fibrinogen was detected and NIHSS was scored within 1 h on admission. Then,the imaging,ultrasound and other laboratory tests were given. Results The mean plasma concentration of fi-brinogen in LAA group and SAO group was respectively(3. 51 ± 0. 74)g / L,(3. 00 ± 0. 73)g / L,and (2. 53 ± 0. 16)g / L in the control group. The fibrinogen levels were significantly higher in LAA group than that in SAO group,however,that in both group were higher than that in the control group(P < 0. 05). The mean NIHSS score in LAA group and SAO group was respectively 7. 29 ± 5. 29 and 3. 13 ± 1. 13, there was significant difference(P = 0. 035). And fibrinogen level was positively correlated with NIHSS scores(r = 0. 639,P = 0. 013),the regression equation was NIHSS = -5. 224 + 3. 646Fib. The fibrinogen ROC curves showed that the cutoff value which could get the best sensitivity and specificity for differentia-ting LAA from SAO was 3. 00 g / L,and with a sensitivity of 60. 1% ,specificity of 73. 4% ,positive pre-dictive value of 81. 8% ,negative predictive value of 43. 5% . Conclusions Fibrinogen level can be a useful indicator for identifying the early etiological subtypes of acute cerebral infraction,especially for predicting LAA. And it can reflect the severity of cerebral infarction in certain degree.
