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进展性脑梗死患者血清LPA、D-D水平变化及其意义
作者:王信天  陶先明  胥明  周小清 
单位:重庆市大足区人民医院 神经内科, 重庆 402360
关键词:进展性脑梗死 溶血磷脂酸 D-二聚体 预测 
分类号:R743.3
出版年·卷·期(页码):2021·49·第四期(424-428)
摘要:

目的:分析进展性脑梗死患者血清溶血磷脂酸(LPA)、D-二聚体(D-D)水平的变化及其意义。方法:急性脑梗死患者99例均来源于我院门诊2015年2月至2018年1月收治的病例,分为进展性脑梗死组(n=41)与非进展性脑梗死组(n=58),同期健康体检者30例作为对照组,对照组体检当日采血,脑梗死患者于入院时、入院24 h、入院48 h采血,测定血清LPA、D-D水平,分析LPA、D-D水平对进展性脑梗死的早期预测价值及两者与进展性脑梗死神经功能损害的关系。结果:非进展性脑梗死、进展性脑梗死患者血清LPA、D-D水平均高于对照组(P<0.05),进展性脑梗死组入院不同时间点LPA、D-D水平又高于非进展性脑梗死组(P<0.05);进展性脑梗死组入院48 h NIHSS评分及入院时、入院48 h NIHSS评分差值均高于非进展性脑梗死组(P<0.05);D-D水平>447.10μg·L-1时预测进展性脑梗死曲线下面积为0.811,敏感性、特异性分别为87.50%、77.97%;LPA水平>6.57 μmol·L-1时预测敏感性、特异性分别为77.50%、94.92%;进展性脑梗死患者血清LPA、D-D水平与NIHSS评分呈正相关(P<0.05)。结论:进展性脑梗死患者血清LPA、D-D水平较非进展性脑梗死患者高,且与患者神经功能受损程度密切相关,可作为早期预测脑梗死进展及病情变化的依据。

Objective: To analyze the significance of changes of serum lysophosphatidic acid (LPA) and D-dimer (D-D) levels in patients with progressive cerebral infarction. Methods: A total of 99 patients with acute cerebral infarction who were treated in the hospital from February 2015 to January 2018 were divided into progressive cerebral infarction group (n=41) and non-progressive cerebral infarction group (n=58). Meanwhile, 30 healthy subjects were selected as the control group. Blood samples of the control group were collected on the day of physical examination and those of patients with acute cerebral infarction were collected at admission, 24 h and 48 h after admission to measure serum LPA and D-D levels. Value of LPA and D-D levels in early prediction of progressive cerebral infarction, the relationship between the two and neurological impairment of progressive cerebral infarction were analyzed. Results: Serum LPA and D-D levels in patients with cerebral infarction were higher than those in the control group (P<0.05). Besides, LPA and D-D levels in progressive cerebral infarction group were higher than those in non-progressive cerebral infarction group at different time points after admission (P<0.05). The NIHSS score of progressive cerebral infarction group was higher than that of non-progressive cerebral infarction group at 48 h after admission, and difference value of the NIHSS score between 48 h after admission and admission of progressive cerebral infarction group was also higher (P<0.05). When the D-D level was higher than 447.10 μg·L-1, the area under the curve for prediction of progressive cerebral infarction was 0.811, and the sensitivity and specificity were 87.50% and 77.97%. When the LPA was higher than 6.57 μmol·L-1, the predictive sensitivity and specificity were 77.50% and 94.92%. Serum LPA and D-D levels in patients with progressive cerebral infarction were positively correlated with the NIHSS score (P<0.05). Conclusion: Serum LPA and D-D levels in patients with progressive cerebral infarction are higher than those in patients with non-progressive cerebral infarction, which are closely related to the degree of neurological impairment and can be used for early prediction of cerebral infarction progression and changes in patients' condition.

参考文献:

[1] SRETTABUNJONG S.Septic cavernous sinus thrombosis following a minor head injury:a rare cause of medico-legal death[J].J Forensic Sci,2018,63(6):1888-1891.
[2] 刘瑷瑜,张少轲,谈畅,等.ApoE基因多态性与缺血性卒中的相关性研究[J].东南大学学报(医学版),2019,38(6):941-946.
[3] FOLSOM A R,GOTTESMAN R F,APPIAH D,et al.Plasma D-dimer and incident ischemic stroke and coronary heart disease:the atherosclerosis risk in communities study[J].Stroke,2016,47(1):18-23.
[4] BRIEN A,MARSHALL C R,BLASER S,et al.Severe neurodegeneration,progressive cerebral volume loss and diffuse hypomyelination associated with a homozygous frameshift mutation in CSTB[J].Eur J Hum Genet,2017,25(6):775-778.
[5] YUAN W,SHI Z H.The relationship between plasma D-dimer levels and outcome of Chinese acute ischemic stroke patients in different stroke subtypes[J].J Neural Transm,2014,121(4):409-413.
[6] 徐运,刘鸣.第15次中国脑血管病大会2015会议纪要[J].中华神经科杂志,2015,48(10):925-926.
[7] 谈颂,常思远,宋波,等.早期改良美国国立卫生研究院卒中量表评分对缺血性卒中预后的预测作用[J].中华神经科杂志,2012,45(3):154-157.
[8] HSU P J,CHEN C H,YEH S J,et al.High plasma D-dimer indicates unfavorable outcome of acute ischemic stroke patients receiving intravenous thrombolysis[J].Cerebrovasc Dis,2016,42(1-2):117-121.
[9] 王璐,钟琪,毕晓莹.急性脑梗死患者Hcy ox-LDL D-二聚体的表达水平及意义[J].安徽医学,2018,39(10):1268-1271.
[10] NEZU T,KITANO T,KUBO S,et al.Impact of D-dimer levels for short-term or long-term outcomes in cryptogenic stroke patients[J].J Neurol,2018,265(3):1-9.
[11] UMEMURA T,HACHISUKA K,MIYACHI H,et al.Clinical outcomes of cerebral infarction in nonagenarians compared among four age groups[J].Neurol Sci,2020,41(9):2471-2476.
[12] 朱晔,王琳琳,曹文隽.脑梗死伴低钠血症患者B-型尿钠肽、白介素-6、D-二聚体水平变化及检测意义[J].实用医院临床杂志,2018,15(6):214-216.
[13] YU Y,QIN J,LIU M,et al.Role of Rho kinase in lysophosphatidic acid-induced altering of blood-brain barrier permeability[J].Int J Mol Med,2014,33(3):661-669.
[14] 嵇朋,杨佳蕾,李小刚.血浆N末端B型钠尿肽前体和D-二聚体对急性脑梗死患者预后影响的研究[J].中华老年心脑血管病杂志,2018,20(10):1058-1061.
[15] WISEMAN S,MARLBOROUGH F,DOUBAl F,et al.Blood markers of coagulation,fibrinolysis,endothelial dysfunction and inflammation in lacunar stroke versus non-lacunar stroke and non-stroke:systematic review and meta-analysis[J].Cerebrovasc Dis,2014,37(1):64-75.
[16] 刘书芳,汪琳,彭聪,等.急性脑梗死患者血清sICAM-1、VS-2、D-二聚体水平的变化及意义[J].中国老年学杂志,2018,38(6):1319-1321.
[17] 李有中,郑重,谢康.动脉粥样硬化性脑梗死病人胱抑素C、同型半胱氨酸、超敏C反应蛋白和D-二聚体联合检测的临床意义[J].蚌埠医学院学报,2018,43(5):589-591.
[18] DANESE E,MONTAGNANA M,CERVELLIN G,et al.Hypercoagulability,D-dimer and atrial fibrillation:an overview of biological and clinical evidence[J].Ann Med,2014,46(6):364-371.
[19] 常霞.动脉粥样硬化血栓形成性脑梗死血清D-二聚体与神经功能、脑梗死面积的关系[J].血栓与止血学,2017,23(6):981-982.
[20] 赵维川,武英伟,刘敏,等.脂蛋白相关磷脂酶A2、D-二聚体、抗凝血酶Ⅲ与急性脑梗死的相关性分析[J].国际检验医学杂志,2017,38(16):2222-2223,2226.

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