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目的探讨老年短暂性脑缺血发作(TIA)与C反应蛋白(CRP)和血浆D-二聚体(D-dimer,D-D)的关系。方法将中国医科大学附属第二医院2003-06~2005-06收治的92例老年TIA患者按病程划分为3组:TIA持续60min内缓解为A组(35例);TIA超过60min,并反复发作,但无持久的神经缺损症状,无脑梗死发生者为B组(31例);以TIA起病,以后发展成为脑梗死为C组(26例)。所有病例在起病24h内检测血清CRP和D-D的质量浓度,观察72h内头CT或MRI,将结果与正常对照组28名进行组间比较。结果TIA患者血清CRP和D-D的质量浓度高于对照组(P<0·01),B、C组均高于A组(P<0·01),且C组高于B组(P<0·05),TIA各组CRP和D-D质量浓度均呈显著正相关。结论(1)CRP是D-D升高的主要相关因素。(2)CRP和D-D的升高可能是老年TIA患者的危险因素。(3)CRP和D-D的升高可以对老年TIA患者的诊断、治疗和估计预后提供较可靠的实验室指标。
Objective To investigate the relationship between TIA and C-reactive protein (CRP) and plasma D-dimer (D-dimer) in elderly patients with transient ischemic attack. Methods Ninety-two elderly TIA patients admitted to the Second Affiliated Hospital of China Medical University from June 2003 to June 2005 were divided into three groups according to the course of their disease: TIA was relieved in Group A (60 cases) in 60 minutes, and TIA exceeded 60 minutes , But no persistent neurological deficit symptoms, no cerebral infarction occurred in group B (31 cases); TIA onset, later developed into cerebral infarction in group C (26 cases). In all cases, serum CRP and D-D concentrations were measured within 24 hours of onset, and CT or MRI within 72 hours were observed. The results were compared with 28 normal controls. Results The serum concentrations of CRP and DD in TIA patients were significantly higher than those in control group (P <0.01), those in B and C groups were significantly higher than those in A group (P <0.01) · 05), TIA CRP and DD concentrations were significantly correlated with each other. Conclusion (1) CRP is the main factor related to the increase of D-D. (2) Elevated CRP and D-D may be risk factors for elderly TIA patients. (3) The elevated CRP and D-D can provide more reliable laboratory indicators for the diagnosis, treatment and prognosis of elderly patients with TIA.