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目的探讨急性脑梗死患者治疗前后血清Hcy、hs-CRP、BNP和血浆D-二聚体(d-dimer,D-D)水平的变化与疾病诊断、治疗之间的关系及临床意义。方法选择2013年1月—2014年6月收治的急性脑梗死患者47例作为观察组,另选择同期在本院体检中心进行健康体检合格者40例作为对照组。检测并比较两组Hcy、hs-CRP、BNP和D-D水平及观察组治疗前后各指标变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,两变量关系采用Pearson相关分析,P<0.05为差异有统计学意义。结果观察组治疗前Hcy、hs-CRP、BNP和血浆D-D水平分别为(22.1±8.4)μmol/L、(3.3±1.2)mg/L、(31.4±16.2)pg/ml、(2.53±0.34)mg/L,明显高于对照组的(8.4±3.0)μmol/L、(1.0±0.49)mg/L、(9.2±5.1)pg/ml、(0.24±0.13)mg/L,差异均有统计学意义(均P<0.05)。观察组治疗后Hcy、hs-CRP、BNP和血浆D-D水平分别为(8.3±3.2)μmol/L、(1.1±0.5)mg/L、(9.6±5.9)pg/ml、(0.26±0.11)mg/L,较治疗前均明显降低,治疗前后比较差异均有统计学意义(均P<0.05)。血清Hcy水平与hs-CRP、BNP和血浆D-D水平呈正相关,差异均有统计学意义(r=0.6157、0.5283、0.5832,均P<0.05)。结论 Hcy、hs-CRP、BNP、D-D是反映病情发展的良好的实验室指标,检测其水平变化对指导急性脑梗死的诊断、临床治疗及预后判断具有重要的临床意义。
Objective To investigate the relationship between the changes of serum Hcy, hs-CRP, BNP, D-dimer and the diagnosis and treatment of patients with acute cerebral infarction before and after treatment and its clinical significance. Methods Forty-seven patients with acute cerebral infarction admitted from January 2013 to June 2014 were selected as the observation group. Another 40 healthy people who passed the physical examination in our hospital during the same period were selected as the control group. The levels of Hcy, hs-CRP, BNP and D-D in the two groups were detected and compared, and the changes of each index in the observation group before and after treatment were observed. The t test was used to compare the measurement data. The paired t test was used to compare the two groups. Pearson correlation analysis was used to analyze the relationship between the two variables. P <0.05 was considered as significant difference. Results The levels of Hcy, hs-CRP, plasma BNP and plasma DD in the observation group before treatment were (22.1 ± 8.4) μmol / L, 3.3 ± 1.2 mg / L, 31.4 ± 16.2 pg / ml and 2.53 ± 0.34, (8.4 ± 3.0) μmol / L, (1.0 ± 0.49) mg / L, (9.2 ± 5.1) pg / ml, and (0.24 ± 0.13) mg / L respectively in the control group Significance (both P <0.05). The levels of Hcy, hs-CRP, BNP and plasma DD in the observation group were (8.3 ± 3.2) μmol / L, 1.1 ± 0.5 mg / L, 9.6 ± 5.9 pg / ml and 0.26 ± 0.11 mg / L, compared with before treatment were significantly lower, before and after treatment were statistically significant differences (P <0.05). Serum Hcy levels were positively correlated with hs-CRP, BNP and plasma D-D, the differences were statistically significant (r = 0.6157, 0.5283, 0.5832, all P <0.05). Conclusions Hcy, hs-CRP, BNP and D-D are good laboratory parameters reflecting the development of the disease. To detect the changes of their levels has important clinical significance in the diagnosis, clinical treatment and prognosis of acute cerebral infarction.