Chen Xing, Li Sijin, Chen Wei, Xu Fei, Wang Yan, Zou Guoying, Ren Biqiong
Department of Laboratory Medicine, Clinical Medical College, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China.
Department of Laboratory Medicine, Clinical Medical College, Hunan University of Chinese Medicine, Changsha, Hunan 410208, PR China; Clinical Laboratory, The Second People's Hospital of Hunan Province, 427 Furong Road, Changsha, Hunan 410007, PR China.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104918. doi: 10.1016/j.jstrokecerebrovasdis.2020.104918. Epub 2020 May 16.
At present, there is no hematology marker with high specificity to the diagnosis and differential diagnosis of acute ischemic stroke (AIS). How to use the existing test items to improve the diagnosis efficiency worthy of discussion. D-Dimer (DD) and fibrinogen (FIB) were the common indicators in thrombotic diseases, but D-dimer to fibrinogen ratio (D/F) in AIS has not been used in clinical practice. In this work, we focus on the evaluation of D/F.
90 AIS patients were selected as the observation group and 65 other patients without coagulation function disorder as the control group. Meanwhile, a total of 33 patients with other diseases with impaired consciousness in the same period were collected. Based on the AIS patients with or without consciousness disorder divided it into consciousness disorder group and unconsciousness disorder group. Then based on the patients with or without consciousness disorder divided it into other diseases with unconsciousness disorder group and Other diseases with lacunar cerebral infarction (LCI)and disturbance of consciousness group. then compare the differences of plasma DD, FIB and D/F between groups.
All plasma DD, FIB and D/F ratio in AIS patients were significantly higher than in other disease group (P = 0.000, P = 0.001, P = 0.000), but DD, D/F in disorders of consciousness group was significantly higher than in unconsciousness disorders group (P = 0.007, P = 0.005). The DD of the AIS with consciousness disorder group were significantly higher than that of the other disease with consciousness disorder group (P = 0.042), and the DD, D/F ratio of Other diseases with lacunar cerebral infarction and disturbance of consciousness group were significantly higher than one(P = 0.000, P = 0.003). All others are undifferentiated.
When DD, D/F ratio is high, other diseases caused by consciousness disorders are likely to be combined with infarcts, which can be used for the diagnosis and differential diagnosis of patients with different types of consciousness disorders, especially hospitalized patients.
目前，尚无对急性缺血性脑卒中（AIS）诊断及鉴别诊断具有高特异性的血液学标志物。如何利用现有检测项目提高诊断效率值得探讨。D-二聚体（DD）和纤维蛋白原（FIB）是血栓性疾病的常用指标，但AIS中的D-二聚体与纤维蛋白原比值（D/F）尚未应用于临床实践。在本研究中，我们重点评估D/F。
选取90例AIS患者作为观察组，65例无凝血功能障碍的其他患者作为对照组。同时，收集同期共33例意识障碍的其他疾病患者。基于AIS患者有无意识障碍分为意识障碍组和无意识障碍组。然后基于患者有无意识障碍分为其他疾病无意识障碍组和其他疾病伴腔隙性脑梗死（LCI）及意识障碍组。然后比较各组血浆DD、FIB及D/F的差异。
AIS患者的所有血浆DD、FIB及D/F比值均显著高于其他疾病组（P = 0.000，P = 0.001，P = 0.000），但意识障碍组的DD、D/F显著高于无意识障碍组（P = 0.007，P = 0.005）。意识障碍的AIS组的DD显著高于意识障碍的其他疾病组（P = 0.042），其他疾病伴腔隙性脑梗死及意识障碍组的DD、D/F比值显著高于另一组（P = 0.000，P = 0.003）。其他均无差异。
当DD、D/F比值升高时，意识障碍引起的其他疾病可能合并梗死，可用于不同类型意识障碍患者的诊断及鉴别诊断，尤其是住院患者。
