【摘要】 目的探讨血浆纤维蛋白原(FIB)检测在短暂性脑缺血发作(TIA)患者预后判断中的应用价值。方法选择急诊入院的132例TIA患者,均进行ABCD2评分,低危患者46例(0~3分),中危患者70例(4~5分),高危患者16例(6~7分)。采用全自动CA7000血凝仪检测TIA患者血浆FIB。患者预后采用复合终点事件来判断,包括在90 d内脑卒中或死亡、与症状相关≥50%大动脉狭窄或有心源性栓子需抗凝治疗。结果未发生复合终点事件98例(阴性组),发生复合终点事件34例(阳性组)。阳性组与阴性组患者血浆FIB水平分别为(4.53±0.99)、(3.05±0.93)g/L,两组比较,P<0.05。ABCD2评分为低危、中危、高危患者血浆FIB水平分别为(2.98±0.86)、(3.54±1.47)、(5.16±1.68)g/L,三者间比较,P均<0.05。相关性分析结果显示,血浆FIB水平与ABCD2评分呈正相关(r=0.388,P<0.001)。Cox回归分析结果显示,ABCD2≥4分及血浆FIB≥3.5 g/L是TIA患者发生复合终点事件的预测因素(P均<0.05)。结论 TIA发生复合终点事件者血浆FIB水平明显升高,血浆FIB水平与ABCD2评分呈正相关。血浆FIB≥3.5 g/L时可有效判断90 d内TIA患者预后。更多还原

【Abstract】 Objective To explore the predictive value of the level of plasma fibrinogen( FIB) for the prognosis of patients with transient ischemic attack( TIA). Methods 132 patients with acute TIA in hospitalization were enrolled. These patients were divided into low( 0 ~ 3 points,46 patients),mederate( 4 ~ 5 points,70 patients) and high( 6 ~ 7 points,16 patients) risk groups according to their ABCD2 scores. The levels of FIB were detected by using SYSTEX CA-7000 Automated Blood Coagulation Analyzer. The primary outcome measure was a composite endpoint consisting of stroke or death within 90 days; ≥50% stenosis in a artery association with clinical symptoms or cardioembolic source warranting anticoagulation. Results The composite end point occurred in 34 patients( positive group) and was not found in other 98 patients( negative group). The level of FIB was higher in positive group compared to negative group [( 4. 53 ± 0. 99) vs( 3. 05 ±0. 93) g / L,P < 0. 05]. There was significant difference among low-risk,mederate-risk and high-risk groups in the levels of plasma FIB [( 2. 98 ± 0. 86) vs( 3. 54 ± 1. 47) vs( 5. 16 ± 1. 68) g / L,P < 0. 05]. Spearman rank correlation coefficient test showed that the level of plasma FIB was positively correlated with ABCD2 score( r = 0. 388,P < 0. 001). Cox regression analysis showed that ABCD2 score ≥4 and FIB≥3. 5 g / L were significantly associated with the composite endpoint.Conclusion The level of plasma FIB significantly increase in TIA patients with positive composite endpoint,and is positively correlated with ABCD2 score. Using the threshold value of 3. 5 g / L for FIB,there was a trend toward FIB predicting outcome of these patients within 90 days after TIA.更多还原