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目的 为了解缺血性脑梗死病人在不同阶段血浆 Ｄ－ 二聚体测定的意义。方法 随机选择８４ 例到本院急诊科就诊的缺血性脑梗死患者（ 年龄５１ ～９０ 岁，男性４２ 例，女性４２ 例） ，分别于急性期（ ＜ ６ 天，ｎ ＝ ５３ ，年龄５１ ～８７ 岁，平均７０ 岁） 和亚急性期（６ ～２０ 天，ｎ ＝ ３１ ，年龄５３ ～９０ 岁，平均７２ 岁） 行血浆 Ｄ－ 二聚体测定。全部患者均经头颅 Ｃ Ｔ 或 Ｍ Ｒ Ｉ证实为缺血性脑梗死。同时选择年龄相匹配的２０ 例其他非凝血及血栓性疾病患者（ 年龄６０ ～９５ 岁，平均７２ 岁） 作为对照组。结果 缺血性脑梗死患者的血浆 Ｄ－ 二聚体水平在急性期未见升高（ ＜ ０３ｍｇ／ Ｌ） ，而在亚急性期显著升高（ ≥０３ ｍｇ／ Ｌ，０３ ～２ ｍｇ／ Ｌ） ，亚急性期与对照组（ ＜ ０３ ｍｇ／ Ｌ） 比较有显著差异（ Ｐ＜ ００００１） ，与急性期比较也有显著差异（ Ｐ＜ ００００１）（ 正常值为＜ ０３ ｍｇ／ Ｌ） 。结论 缺血性脑梗死患者的纤溶系统显著激活并非在急性期，而是在亚急性期。这也为急性期进行溶栓治疗提供了依据。
Objective To understand the significance of plasma D-dimer in different stages of patients with ischemic cerebral infarction. Methods A total of 84 patients with ischemic stroke (aged 51-90 years, 42 males and 42 females) were enrolled in the emergency department of our hospital. The patients were randomly divided into acute phase (<6 days, n = 53, 87 years old with an average of 70 years) and sub-acute phase (6 to 20 days, n = 31, aged 53 to 90 years, mean 72 years). All patients were confirmed by cranial C T or M R I as ischemic cerebral infarction. At the same time, 20 patients with other non-coagulation and thrombotic diseases (age 60-95 years, average 72 years old) with the same age were selected as the control group. Results The level of plasma D-dimer in patients with ischemic stroke was not increased in the acute phase (<0.3mg / L), but significantly increased in the subacute stage (≥0.3 mg / L, 00 (P <00001) in the subacute stage compared with the control group (<0.3 mg / L), and there was a significant difference compared with the acute phase (P <00001) (P < Normal <0 3 mg / L). Conclusion The fibrinolytic system in patients with ischemic cerebral infarction was significantly activated not in the acute phase but in the subacute phase. This also provides a basis for thrombolytic therapy in acute stage.