平均血小板体积、D-二聚体和纤维蛋白原降解产物与脑梗死及其病变程度的相关性研究

doi:10.3969/j.issn.1673-8640.2021.04.007

摘要/Abstract

摘要：

目的探讨平均血小板体积（MPV）、D-二聚体（DD）和纤维蛋白原降解产物（FDP）与脑梗死（CI）及其梗死体积和神经功能缺损严重程度（NIHSS）评分之间的关系。方法选取2016年1月—2018年12月上海交通大学医学院附属瑞金医院北院303例CI患者作为CI组,另选取同期健康体检者70名作为对照组。检测所有研究对象MPV、DD和FDP水平,分析MPV与DD、FPD的相关性,及不同梗死体积患者MPV、DD和FDP的差异。分析MPV、DD、FDP与NIHSS评分的相关性。结果与对照组比较,CI组MPV、DD和FDP明显升高,差异均有统计学意义（P<0.05）。CI组MPV与DD和FDP呈正相关,差异均有统计学意义（P<0.05）。小梗死灶、中梗死灶、大梗死灶病变患者MPV、DD和FDP水平依次升高,差异均有统计学意义（P<0.05）;MPV、DD和FDP水平与NIHSS评分呈正相关（r=0.871 0,P<0.05;r=0.483 2,P<0.05;r=0.478 1,P<0.05）,MPV与DD、FDP水平存在线性关系（r=0.426 1,P<0.05;r=0.438 9,P<0.05）。结论 MPV、DD、FDP与CI及其病变程度有关,可作为CI患者病变严重程度的独立预测因子,在CI的预后评估中具有一定价值。

关键词: 脑梗死, 平均血小板体积, D-二聚体, 纤维蛋白原降解产物, 梗死体积, 病变程度

Abstract:

Objective To investigate the correlations of mean platelet volume（MPV）,D-dimer（DD） and fibrinogen degradation product（FDP） with cerebral infarction（CI）,its infarct volume and the National Institute of Health stroke scale（NIHSS） score. Methods From January 2016 to December 2018,303 CI patients from the North Campus of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine were enrolled as CI group,and 70 healthy subjects were enrolled as control group. MPV,DD and FDP levels were determined. The difference of MPV,DD and FPD with different infarct volumes was analyzed. The correlations of MPV,DD and FPD with NIHSS score were analyzed. The correlations of MPV with DD and FPD were evaluated. Results Compared with control group,MPV,DD and FDP levels of CI group were increased（P<0.05）. In CI group,MPV was positively correlated with DD and FDP（P<0.05）. The MPV,DD and FDP levels in patients with small infarct size,medium infarct size and large infarct size were increased in turn（P<0.05）. The MPV,DD and FDP levels were positively correlated with NIHSS score（r=0.871 0,P<0.05;r=0.483 2,P<0.05;r=0.478 1,P<0.05）. A linear correlation was found between MPV level and DD and FDP levels（r=0.426 1,P<0.05;r=0.438 9,P<0.05）. Conclusions MPV,DD and FDP are correlated with CI and its pathological degree,they may be used as independent predictors of CI severity and play roles in prognosis assessment.

Key words: Cerebral infarction, Mean platelet volume, D-dimer, Fibrinogen degradation product, Infarct volume, Lesion severity

中图分类号:

R446.1

丁宁, 张卫峰, 陈小勇, 赵克温. 平均血小板体积、D-二聚体和纤维蛋白原降解产物与脑梗死及其病变程度的相关性研究[J]. 检验医学, 2021, 36(4): 384-387.

DING Ning, ZHANG Weifeng, CHEN Xiaoyong, ZHAO Kewen. Correlations of mean platelet volume,D-dimer and fibrinogen degradation product levels with cerebral infarction and its pathological degree[J]. Laboratory Medicine, 2021, 36(4): 384-387.

图/表 5

参考文献 13

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组别	例数	PLT计数/（×10⁹/L）	MPV/fL
对照组	70	195.33±49.10	8.31±0.62
CI组	303	197.70±68.73	9.76±1.56
t值		1.42	7.658
P值		>0.05	<0.01

组别	例数	PLT计数/（×10⁹/L）	MPV/fL
对照组	70	195.33±49.10	8.31±0.62
CI组	303	197.70±68.73	9.76±1.56
t值		1.42	7.658
P值		>0.05	<0.01

组别	DD/（mg/L）	FDP/（g/L）
CI组 1 d	0.53（0.01~20.81）^*	5.40（0.1~218.2）^*
7 d	0.16（0.01~6.8）	1.6（0.1~6.8）
对照组	0.39（0.26~0.45）	3.8（2.5~4.8）

组别	DD/（mg/L）	FDP/（g/L）
CI组 1 d	0.53（0.01~20.81）^*	5.40（0.1~218.2）^*
7 d	0.16（0.01~6.8）	1.6（0.1~6.8）
对照组	0.39（0.26~0.45）	3.8（2.5~4.8）

梗死灶大小	例数	MPV/fL	DD/（mg/L）	FDP/（g/L）
小梗死灶	146	8.5（6.8~11.1）	0.21（0.01~0.06）	2.20（0.1~5.7）
中梗死灶	93	10.2（8.5~13.2）^*	0.85（0.42~1.80）^*	8.50（4.50~19.9）^*
大梗死灶	64	12.0（10.1~13.7）^*#	2.86（1.11~20.81）^*#	31.85（12.10~218.20）^*#