The Clinical Significance Of D Dimer And Fibrinogen Detection In Acute Cerebral Infarction

Objective:Acute cerebral infarction(ACI)is the leading cause of disability among cerebrovascular diseases.The early diagnosis,treatment and outcome evaluation of ACI are of great importance for ACI patients.To date,there are few clinical reports on assessment of the severity and prognosis of ACI using the changes of D-dimer and fibrinogen values in ACI patients.In this study,we observed(1)the differences of plasma D-dimer and fibrinogen between ACI patients and healthy people;(2)the difference of D-dimer and fibrinogen in healthy people and patients with ACI of different severity;(3)the difference of D-dimer and fibrinogen in ACI patients with different prognosis;(4)the correlation between D-dimer,fibrinogen and the prognosis of ACI.We also explored the clinical significance of D-dimer and fibrinogen detection in the severity identification and prognosis of ACI.Methods:Sixty ACI patients,who had the onset less than 1 week,and treated at 981 Hospital of PLA from February 2017 to June 2017 were randomly selected to form the experimental group.The neurological impairment of ACI patients enrolled were evaluated by National Institute of Health Stroke Scale(NIHSS)at admission,and the prognosis of those patients were assessed by Modified Rankin Scale(MRS)3 months after treatment.Meanwhile,sixty healthy people who had physical examination in 981 Hospital of PLA were randomly selected to form the control group.The patients and the healthy people fasted enrolled overnight.Three milliliters of venous blood was collected for the measurement of the fibrinogen and D-dimer.The sex,age,blood pressure status,blood fat status,blood glucose status,smoking and drinking status of subjects enrolled were collected.The D-dimer and fibrinogen between different groups were compared by t test or variance analysis,and the the correlation between D-dimer,fibrinogen and the prognosis of ACI were analyzed by logistic regression analysis.Statistical analyses were performed with SPSS software,v21.0(SPSS Inc,USA).A p-value less than 0.05 was considered statistically significant.Result:1.The levels of D-dimer and fibrinogen in the experimental group were significantly higher than those in the healthy control group(P < 0.05).2.D-dimer levels in different NIHSS groups were significantly different.3.Patients with different NIHSS scores had significantly different D-dimer values,and the values of D-dimer in light,medium,medium heavy and heavy groups increased in turn,suggesting that the level of D-dimer may be related to the severity of the disease,and the higher the level,the more serious the disease.4.Fibrinogen levels in different NIHSS groups were significantly different(F=28.471,p<0.01).5.Comparison of fibrinogen in patients with different NIHSS scores revealed p value between light,medium,medium heavy and heavy groups was less than 0.05.The results showed that the levels of fibrinogen in patients with different NIHSS scores were different.The levels of fibrinogen in light,medium,medium heavy and heavy groups increased in turn,suggesting that the level of fibrinogen may be related to the severity of the disease,and the higher the level,the more serious the disease.6.MRS score indicates the prognosis of acute cerebral infarction.There were differences in D-dimer levels between the group with good prognosis(MRS score < 3)and those with poor prognosis(MRS score < 3).The D-dimer level in the group with good prognosis is lower than that in the group with poor prognosis.Similarly,there were differences in fibrinogen levels between the groups with good prognosis and those with poor prognosis,and those with good prognosis were lower than those with poor prognosis.7.The results of logistic regression analysis showed that considering gender,age,hypertension,diabetes mellitus,hyperlipidemia,smoking and alcohol consumption,elevated D-dimer and fibrinogen are still independent factors associated with poor prognosis(MRS score 3-6 after 3 months)in patients with acute cerebral infarction(experimental group).Controlling other variables,the risk of poor prognosis increased 1.792 times for every 1 mg/L increase in D dimer,and 4.372 times in fibrinogen.Conclusion:1.The mechanism of coagulation and fibrinolysis in patients with acute cerebral infarction is obviously abnormal.The more serious the onset,the higher the detection values of plasma D-dimer and fibrinogen.The worse the short-term prognosis(MRS score 3-6 after 3 months),the higher the D-dimer and fibrinogen detection value.2.Increased D-dimer and fibrinogen levels are still independent risk factors for poor prognosis in patients with acute cerebral infarction considering gender,age,hypertension,diabetes,hyperlipidemia,smoking and drinking(MRS score 3-6 after 3 months).