Abstract:

Objective　To explore the value of D-dimer level in the prediction of the improvement of lesion area after edaravone dexcamphol for progressive cerebral infarction. Methods　The clinical data of 102 patients with progressive cerebral infarction treated at Zhengzhou Central Hospital, Zhengzhou University from January 2023 to April 2024 were selected as the study objects. According to their prognosis, the patients were divided into a good prognosis group (74 cases) and a poor prognosis group (28 cases). The general data and serum indicators of the two groups were compared. The influence of time on the relationship between the D-dimer level and lesion area was analyzed by the hierarchical interaction test using the EmpowerStats software. The correlation between D-dimer level and adverse prognosis risk was analyzed by the multivariate Cox regression analysis. Results　There were statistical differences in the systolic blood pressure, diabetes, hypertension, atrial fibrillation, hyperlipidemia, D-dimer, uric acid (UA), and score of National Institute of Health Stroke Scale (NIHSS) before the treatment between the good prognosis group and the poor prognosis group (all P<0.05). The levels of D-dimer [(219.43±21.67) g/L vs. (172.88±22.11) g/L, (207.67±22.43) g/L vs. (153.79±22.12) g/L, (184.49±22.08) g/L vs. (122.95±22.11) g/L, and (163.59±22.45) g/L vs. (101.69±22.47) g/L] and the Alberta Stroke Program Early CT Scores (ASPECTS) (1.45±0.46 vs. 2.22±0.45, 2.84±0.44 vs. 4.62±0.43, 3.72±0.47 vs. 5.95±0.51, and 5.02±0.58 vs. 7.52±0.45) on the day when the treatment was finished and 1, 2, and 4 weeks after the treatment in the poor prognosis group were worse than those in the good prognosis group, with statistical differences (all P<0.05). There was a correlation between the level of D-dimer and the change of lesion area at each time point (all P<0.05). According to the D-dimer level triplet, the patients were divided into a low-level group (D-dimer<188.27 g/L; 25 cases), a middle-level group (D-dimer 188.27-241.21 g/L; 54 cases), and a high-level group (D-dimer>241.21 g/L; 23 cases); the high-level group had higher adverse prognosis risk than the other two groups (P<0.05). Conclusion　The level of D-dimer has certain predictive value for the improvement of lesion area after edaravone dexcamphol for progressive cerebral infarction, and can be used as an indicator for clinically monitoring the effect of edaravone dexcamphol for progressive cerebral infarction.

Key words:

D-dimer, Edaravone dexcamphol, Progressive cerebral infarction, Lesion area

摘要：

目的　探究D-二聚体水平预测依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善的价值。方法　选取2023年1月至2024年4月郑州大学附属郑州中心医院收治的102例进展性脑梗死患者为研究对象。根据预后情况将患者分为预后良好组（74例）与预后不良组（28例）。比较两组患者一般资料、血清指标。采用EmpowerStats软件中的分层交互作用检验分析时间对D-二聚体水平与病灶面积变化之间关系的影响。采用多元Cox回归分析对D-二聚体水平与预后不良风险的关系进行分析。结果　预后良好组、预后不良组收缩压、糖尿病、高血压、心房颤动、高脂血症、D-二聚体、尿酸（UA）、治疗前美国国立卫生研究院卒中量表（National Institute of Health Stroke Scale，NIHSS）评分差异均有统计学意义（均P<0.05）。治疗后当天、1、2、4周，预后不良组D-二聚体水平［（219.43±21.67）g/L比（172.88±22.11）g/L、（207.67±22.43）g/L比（153.79±22.12）g/L、（184.49±22.08）g/L比（122.95±22.11）g/L、（163.59±22.45）g/L比（101.69±22.47）g/L］、Alberta卒中项目早期CT评分（Alberta Stroke Program Early CT Score，ASPECTS）［（1.45±0.46）分比（2.22±0.45）分、（2.84±0.44）分比（4.62±0.43）分、（3.72±0.47）分比（5.95±0.51）分、（5.02±0.58）分比（7.52±0.45）分］均差于预后良好组，差异均有统计学意义（均P<0.05）。各时间点D-二聚体水平与病灶面积变化存在相关性（均P<0.05）。根据D-二聚体水平三分位数将患者分为低水平组（D-二聚体<188.27 g/L，25例）、中水平组（D-二聚体188.27～241.21 g/L，54例）和高水平组（D-二聚体>241.21 g/L，23例），高水平组患者预后不良风险均高于其他两组（P<0.05）。结论　D-二聚体水平对依达拉奉右莰醇治疗进展性脑梗死后病灶面积改善具有一定的预测价值，可作为临床监测依达拉奉右莰醇治疗进展性脑梗死患者效果的指标。

关键词:

D-二聚体, 依达拉奉右莰醇, 进展性脑梗死, 病灶面积