CAJ | 학술논문

目的：探讨急性脑梗死患者血浆 D -二聚体水平变化及其与病情和预后的关系。方法选取常熟市第二人民医院神经内科2012年收治的259例急性脑梗死患者作为梗死组，选取同期200例体检健康者作为对照组，梗死组患者于入院24 h 内、对照组受检者于体检当日清晨空腹采集静脉血检测血浆 D -二聚体水平。按入院当天美国国立卫生研究院卒中量表（NIHSS）评分将梗死组患者分为轻型（0~15分）组129例、中型（16~25分）组92例、重型（26~33分）组38例。按预后（即住院4周时 NIHSS 评分）将梗死组患者分为好转组182例和无好转组77例。比较对照组与梗死组、梗死组各亚组间血浆 D -二聚体水平及 D -二聚体异常率。结果梗死组血浆 D -二聚体水平为（0.46±0.52）mg/ L、D -二聚体异常率43.2％，均高于对照组的（0.13±0.29） mg/ L、1.0％（P ＜0.05）。轻型组患者血浆 D -二聚体水平为（0.27±0.13）mg/ L、D -二聚体异常率30.5％，分别低于中型组的（0.42±0.28） mg/L、47.8％，中型组又低于重型组的（0.65±0.32） mg/ L、76.3％（P ＜0.05）。好转组患者血浆 D -二聚体水平为（0.31±0.26）mg/ L、D -二聚体异常率32.9％，低于无好转组的（0.57±0.29）mg/ L、67.5％（P ＜0.05）。结论急性脑梗死患者血浆 D -二聚体水平明显升高，且血浆 D -二聚体水平越高患者病情越严重、预后越差。
목적：탐토급성뇌경사환자혈장 D -이취체수평변화급기여병정화예후적관계。방법선취상숙시제이인민의원신경내과2012년수치적259례급성뇌경사환자작위경사조，선취동기200례체검건강자작위대조조，경사조환자우입원24 h 내、대조조수검자우체검당일청신공복채집정맥혈검측혈장 D -이취체수평。안입원당천미국국립위생연구원졸중량표（NIHSS）평분장경사조환자분위경형（0~15분）조129례、중형（16~25분）조92례、중형（26~33분）조38례。안예후（즉주원4주시 NIHSS 평분）장경사조환자분위호전조182례화무호전조77례。비교대조조여경사조、경사조각아조간혈장 D -이취체수평급 D -이취체이상솔。결과경사조혈장 D -이취체수평위（0.46±0.52）mg/ L、D -이취체이상솔43.2％，균고우대조조적（0.13±0.29） mg/ L、1.0％（P ＜0.05）。경형조환자혈장 D -이취체수평위（0.27±0.13）mg/ L、D -이취체이상솔30.5％，분별저우중형조적（0.42±0.28） mg/L、47.8％，중형조우저우중형조적（0.65±0.32） mg/ L、76.3％（P ＜0.05）。호전조환자혈장 D -이취체수평위（0.31±0.26）mg/ L、D -이취체이상솔32.9％，저우무호전조적（0.57±0.29）mg/ L、67.5％（P ＜0.05）。결론급성뇌경사환자혈장 D -이취체수평명현승고，차혈장 D -이취체수평월고환자병정월엄중、예후월차。
Objective To investigate the changes of plasma D - dimer level and its relationship to illness severity and prognosis in patients with acute cerebral infarction. Methods In 2012 in the Second People's Hospital of Changshu,259 pa- tients with acute cerebral infarction were selected as case group,200 healthy cases were selected as control group. Case group detected plasma D - dimer level in the first 24 hours after admission,control group detected plasma D - dimer level on the day of examination. According to NIHSS score,patients of case group were divided into slight group(0 to 15 points,n ﹦ 129),mild group(16 to 24 points,n ﹦ 38),severe group(26 to 33 points,n ﹦ 38);according to the prognosis(NIHSS score after 4 weeks of admission),patients of case group were divided into A group(with better prognosis,n ﹦ 182) and B group( with general prognosis,n ﹦ 77). Plasma D - dimer level and abnormal rate of D - dimer between case group and control group,a- mong different subgroups were compared. Results The plasma D - dimer level of case group was(0. 46 ± 0. 52) mg/ L,the abnormal rate of D - dimer was 43. 2% ,was higher than that of control group of(0. 13 ± 0. 29) mg/ L,1. 0% ,respectively (P < 0. 05). The plasma D - dimer level of slight group was(0. 27 ± 0. 13) mg/ L,the abnormal rate of D - dimer was 30. 5% ,was lower than that of mild group of(0. 42 ± 0. 28) mg/ L,47. 8% ,respectively( P < 0. 05),and that of mild group was lower than that of severe group of(0. 65 ± 0. 32)mg/ L,76. 3% ,respectively(P < 0. 05). The plasma D - dimer level of A group was(0. 31 ± 0. 26) mg/ L,the abnormal rate of D - dimer was 32. 9% ,was lower than that of B group of (0. 57 ± 0. 29)mg/ L,67. 5% ,respectively(P < 0. 05). Conclusion The plasma D - dimer level is significantly increased in patients with acute cerebral infarction,and the higher plasma D - dimer level,the more serious illness and worse prognosis.