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D-二聚体联合同型半胱氨酸监测在脑梗治疗中的临床意义
作者:陈元媛1  谭兵2 
单位:1. 荆门市中医医院 检验科, 湖北 荆门 448000;
2. 荆门市中医医院 脑病科, 湖北 荆门 448000
关键词:脑梗死 D-二聚体 同型半胱氨酸 
分类号:R743.33
出版年·卷·期(页码):2018·46·第三期(268-272)
摘要:

目的:探讨D-二聚体(DD)联合同型半胱氨酸(Hcy)在急性脑梗死(ACI)治疗中的临床意义。方法:选择2015年5月至2016年12月我院收治的ACI患者102例(ACI组),分为不同梗死灶组(小、中、大梗死灶)、不同病情程度组(轻、中、重型),分别在发病6 h、24 h、3 d、7 d、14 d、21 d采集静脉血测定血浆Hcy和DD水平,并与40例健康体检者(对照组)比较。结果:ACI组的Hcy急性期显著升高,发病3 d内达高峰(P<0.05),7 d后明显下降,21 d时与对照组无明显差异(P>0.05);DD急性期显著升高,发病7 d内达高峰,14 d后明显下降,但仍显著高于对照组(P<0.05);大面积梗死的ACI患者的Hcy、DD显著高于中、小面积梗死,且中面积梗死显著高于小面积梗死(P<0.05);重型ACI患者的Hcy、DD显著高于中、轻型,且中型显著高于轻型(P<0.05)。结论:血浆DD和Hcy水平与ACI发生、发展及转归密切相关,联合监测两项指标对ACI的病情判断及治疗决策具有重要指导意义。

Objective: To investigate the clinical significance of the cooperative monitoring of D-dimer(DD) and homocysteine(Hcy) in the treatment of acute cerebral infarction (ACI).Methods: 102 cases of ACI patients who admitted in our hospital from May 2015 to December 2016 were enrolled as ACI group,all were divided into different infarct size group (small, medium and large infarct), different degree of disease group (mild, medium and severe).The plasma levels of Hcy and DD at 6 h,24 h,3 d,7 d,14 d,21 d after onset were detected,the results were compared with 40 healthy subjects (control group). Results: The plasma level of Hcy in ACI group increased in acute stage,reached the peak at 3 d after onset (P<0.05),declined remarkably at 7 d later and got nearly normalized within 21 d(P>0.05); The plasma level of DD in ACI group increased in acute stage,reached the peak at 7 dafter onset (P<0.05),declined remarkably at 14 d later,but the results were significantly different from those in the control group (P<0.05);The plasma levels of Hcy and DD in large infarct size group showed obviously higher than those of the medium and small infarct size group,and the level in the medium infarct size group was obviously higher than that in the small infarct size group (P<0.05);The plasma levels of Hcy and DD in severe group showed obviously higher than those in the medium and mild group,and the level in medium groupwasobviously higher than that in the mild group (P<0.05).Conclusion: The plasma levels of Hcy and DD are closely related to the occurrence, development and outcome of ACI, cooperative monitoring of the two indexes can help to judge the condition and guide the treatment of ACI.

参考文献:

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