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目的探讨急性脑梗死(acute cerebral infarction,ACI)患者凝血功能指标变化及其影响因素。方法采用回顾性研究,分析96例急性脑梗死患者及108例健康体检者凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、D二聚体(D-D)、抗凝血酶活性(AT)、纤维蛋白(原)降解产物(FDP)检测指标差异。采用多元逐步直线回归筛选急性脑梗死相关凝血指标的影响因素。结果急性脑梗死患者凝血酶原时间、国际标准化比值、抗凝血酶活性、纤维蛋白(原)降解产物分别为(10.61±0.73)s、(0.96±0.06)%、(98.78±14.52)%、0.84(0.5,1.52)μg/ml,均高于健康体检者,而凝血酶时间(13.77±1.15)s低于健康体检者,差异有统计学意义(P<0.05)。凝血酶原时间与总胆固醇存在负相关关系,凝血酶时间与纤维蛋白原和抗凝血酶活性呈负相关,与患者年龄呈正相关,抗凝血酶活性与凝血酶时间、性别、年龄呈负相关,与空腹血糖呈正相关。结论急性脑梗死病患存在凝血、抗凝、纤溶等功能动态变化,可通过临床凝血指标检测进行病情评估。
Objective To investigate the changes of coagulation parameters and its influencing factors in patients with acute cerebral infarction (ACI). Methods A retrospective study was conducted to analyze the relationship among PT, INR, APTT, TT in 96 patients with acute cerebral infarction and 108 healthy controls. , Fibrinogen (Fib), D dimer (DD), antithrombin activity (AT) and fibrinogen (FDP) were measured. Factors influencing the screening of coagulation index in acute cerebral infarction by multivariate stepwise linear regression. Results The prothrombin time, international normalized ratio, antithrombin activity, and fibrin degradation products in patients with acute cerebral infarction were (10.61 ± 0.73) s, (0.96 ± 0.06)% and (98.78 ± 14.52)%, respectively 0.84 (0.5,1.52) μg / ml, respectively, which were all higher than those of healthy subjects. Thrombin time was lower than that of healthy subjects (13.77 ± 1.15) s, the difference was statistically significant (P <0.05). Prothrombin time was negatively correlated with total cholesterol. Thrombin time was negatively correlated with fibrinogen and antithrombin activity, and was positively correlated with patient age. Antithrombin activity was negatively correlated with time, sex, and age of thrombin Related to fasting blood glucose was positively correlated. Conclusion There are coagulation, anticoagulation, fibrinolysis and other functions in patients with acute cerebral infarction. The clinical evaluation can be made by clinical coagulation test.