D-二聚体与纤维蛋白原比值与青年急性脑梗死患者颈动脉粥样硬化斑块的相关性分析

doi:10.3969/j.issn.1673-5765.2021.08.009

摘要/Abstract

摘要： 目的探讨青年急性脑梗死（young acute cerebral infarction，YACI）患者D-二聚体与纤维蛋白原比值（D-dimer to fibrinogen ratio，DFR）与颈动脉粥样硬化斑块的关系。方法回顾性连续收集2014年2月-2020年9月进行了颈动脉斑块超声造影（contrast-enhanced ultrasound，CEUS）检查的首次发病的YACI患者为观察组，根据CEUS检查结果将颈动脉斑块分为1～4 级；根据NIHSS评分将患者的神经功能缺损分为轻、中、重度。另外选取同期进行了颈动脉超声检查且结果正常的体检青年人作为对照组。收集两组的人口学信息、血管危险因素及实验室检查结果，根据凝血功能结果中的D-二聚体及纤维蛋白原水平计算DFR。比较观察组和对照组上述指标的差异；对观察组中DFR与颈动脉斑块分级和神经功能缺损的严重程度进行相关性分析。结果研究共纳入观察组96例，对照组67例。观察组DFR数值高于对照组（[ 102.06±13.05）×10-3 vs（71.35±18.13）×10-3]，差异有统计学意义（P =0.019）；观察组中DFR数值与神经能缺损严重程度呈正相关（r =0.716，P =0.038），与颈动脉斑块CEUS分级也呈正相关（r =0.879，P =0.032）。结论 YACI患者的DFR数值与颈动脉斑块分级及神经功能缺损严重程度有关，可能是判断YACI患者颈动脉斑块稳定性及病情严重程度的新的标志物。

文章导读： 本研究对伴有颈动脉粥样硬化斑块的YACI患者资料进行了回顾性分析，发现DFR可能反映患者颈动脉粥样硬化斑块的病变程度及神经功能缺损的严重程度。

关键词: D-二聚体与纤维蛋白原比值; 急性脑梗死; 青年; 颈动脉斑块; 神经功能缺损; 危险

Abstract: Objective To explore the relationship between D-dimer to fibrinogen ratio (DFR) and carotid plaque in young acute cerebral infarction (YACI) patients. Methods The first-onset YACI patients who underwent contrast enhanced ultrasound (CEUS) from February 2014 to September 2020 were retrospectively collected and taken as the observation group. The healthy young people with normal carotid ultrasound results in physical examination during the same period were selected as the control group. According to the results of CEUS, carotid plaque was divided into 1-4 grades. According to NIHSS score, the neurological deficits were divided into mild, moderate and severe grades. The demographic information, vascular risk factors and laboratory examination results of the two groups were collected, and DFR was calculated. The differences of the above indexes between the two groups were compared. The correlation of DFR with carotid plaque grade and the severity of neurological deficit in the observation group were analyzed. Results 96 cases in the observation group and 67 cases in the control group were included in this study. The DFR value of the observation group was higher than that of the control group [(102.06±13.05)×10-3 vs (71.35±18.13)×10-3, P =0.019] . In the observation group, DFR was positively correlated with NIHSS score (r =0.716, P =0.038) and CEUS grade of carotid plaque (r =0.879, P =0.032) .

Conclusions The DFR value of YACI patients was positively correlated with CEUS carotid plaque

grade and NIHSS score. The DFR maybe a potential marker for evaluating carotid plaques stability and stroke severity in YACI patients.

Key words: D-dimer to fibrinogen ratio; Acute cerebral infarction; Youth; Carotid plaque;Neurological deficit; Risk factor

侯瑞华, 吕麦扣, 温慧军. D-二聚体与纤维蛋白原比值与青年急性脑梗死患者颈动脉粥样硬化斑块的相关性分析[J]. 中国卒中杂志, 2021, 16(08): 805-809.

HOU Rui-Hua, LYU Mai-Kou, WEN Hui-Jun. Correlation between D-dimer to Fibrinogen Ratio and Carotid Plaque in Young Patients with Acute Cerebral Infarction[J]. Chinese Journal of Stroke, 2021, 16(08): 805-809.

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