关键词: 急性脑梗死, 平均血小板体积, D-二聚体

Abstract:

Objective To investigate the diagnostic roles of platelet parameters and coagulation function index on different infarct sites and severity of acute cerebral infarction(ACI). Methods Totally，126 patients with ACI within 6-72 h of onset admitted to the Northern Branch of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from January 2021 to December 2021 were enrolled. Totally，70 healthy subjects who underwent cranial magnetic resonance imaging(MRI) with negative results were enrolled as control group. According to MRI results，the patients were classified into lobar infarction group，cerebellar infarction group，lateral ventricle infarction group and basal node infarction group. All the research subjects received mean platelet volume(MPV) and D-dimer(DD) determinations within 24 h of onset，and they were classified into normal MPV and DD group and high MPV and DD group. The differences of MPV and DD among patients with different infarct sites of ACI were compared. Pearson correlation analysis was used to assess the correlation of MPV and DD with the severity of the National Institutes of Health Stroke Scale(NIHSS). Receiver operating characteristics(ROC) curve was used to evaluate the diagnostic value of MPV combined with DD in different infarct sites of ACI. Multivariate COX regression was used to analyze the influencing factors of ACI. Results There was statistical significance in MPV and DD levels among lobar infarction group，cerebellar infarction group，lateral rentricle infarction group and basal node infarction group(P<0.05). The cerebral infarction rate of ACI patients in high MPV and DD group was higher than that in normal MPV and DD group(P<0.05). With the increase of infarct volume，MPV and DD levels in ACI patients were increased(P<0.05). MPV level was positively correlated with NIHSS score(r=0.625 9，P<0.01；r=0.543 8，P<0.01). The areas under curves of MPV combined with DD for diagnosing lobar infarction，cerebellar infarction，lateral ventricle infarction and basal node infarction were 0.775 3，0.832 5，0.903 6 and 0.698 1，respectively. MPV[hazard ratio(HR)=0.59，95% confidence interval(CI) 0.39-0.89] and DD(HR=0.77，95%CI 0.61-0.97) were the influencing factors of ACI. Conclusions MPV，DD and MRI play roles in improving the diagnosis of ACI in different infarct sites.

Key words: Acute cerebral infarction, Mean platelet volume, D-dimer