目的: 分析检测急性缺血性脑卒中患者在急性发作期和溶栓治疗有效后的血小板相关参数(PLT和MPV)及止凝血标志物(FIB、FDP、D-D dimmer)的变化及临床意义,并评估吸烟、糖尿病、高血压、高血脂等风险因素与急性缺血性脑卒中发病的相关性。方法: 收集309例急性缺血性脑卒中患者(观察组)发病24 h内的血液样本和303例健康体检者(对照组)的血液样本,检测两组血小板参数(PLT和MPV)及止凝血标志物纤维蛋白原(FIB)、纤维蛋白降解产物(FDP)、D-D二聚体在急性发作期及溶栓治疗有效后的水平,对两组间及观察组治疗前后的数据结果进行对比,分析观察组内吸烟、糖尿病、高血压、高血脂等风险因素与急性缺血性脑卒中发病的相关性。结果: 与对照组相比急性缺血性脑卒中患者血液中PLT降低,MPV增大,D-D二聚体、FIB、FDP水平较高,两组间的差异有统计学意义(P＜0.05),观察组急性发作期和溶栓治疗有效后其水平也有显著性差异,糖尿病、高血压、高血脂、吸烟等风险因素与急性缺血性脑卒中的发病有相关性。结论: 血小板参数PLT、MPV和止凝血标志物D-D二聚体、FIB、FDP联合检测可为院前急性缺血性脑卒中的发病和治疗效果评估提供重要的参考依据。
Objective: To investigate the changes and clinical significance of platelet (PLT) parameters, fibrinogen (FIB), fibrinogen degradation products (FDP), and D-D two dimers in acute ischemic stroke patients after thrombolytic therapy, and to assess the correlation between smoking, diabetes, hypertension, and hyperlipidemia with acute ischemic stroke. Methods: The blood samples of 309 patients with acute ischemic stroke (the observation group) within 24 hours of onset and 303 healthy people (the control group) were collected. The platelet parameters (PLT and MPV) and the levels of fibrinogen (FIB), fibrinolytic products (FDP) and D-D dimer in the acute attack stage and after thrombolytic treatment were measured, the data of the two groups and the observation group before and after treatment were compared, and the correlation between the risk factors (diabetes, hypertension, hyperlipidemia, smoking) and the incidence of acute ischemic stroke in the observation group were analyzed. Results: Comparing with the control group, the level of PLT decreased and MPV increased in the observation group, and the levels of D-Dimer, FIB and FDP of the observation group were higher. The difference between the two groups was statistically significant (P＜0.05). The levels PLT, MPV, D-Dimer, FIB and FDP at acute attack stage and after thrombolytic therapy in the observation group were also significantly different. Smoking and other risk factors, such as diabetes, hypertension, hyperlipidemia, are correlated with the incidence of acute ischemic stroke. Conclusion: The combined detection of PLT, MPV and anticoagulant markers D-D dimer, FIB and FDP could provide an important reference for the evaluation of treatment effect of prehospital acute ischemic stroke.
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