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背景:研究表明血浆中D-二聚体和纤维蛋白原与心脑血管疾病发生前的血凝状态密切相关。目的:分析老年心脑血管疾病患者及老年和中青年健康对照者血浆中血栓前状态分子标志物和纤维蛋白原水平差异。设计:以患者为观察对象,病例分析。单位:一所军区总医院的干部病房。对象:2000-10/2002-03解放军沈阳军区总医院第二干部病房收治的冠心病患者153例、脑血管疾病患者116例,年龄均≥60岁。另选择来本院体检的<60岁健康者68例为中青年对照组,≥60岁健康者98例为老年对照组。方法:于入院后第2天取静脉血2mL(服用阿司匹林者停药4d采血),取血浆用法国Stago公司提供的STA-Compat全自动血凝仪和试剂盒,用免疫比浊法测定D-二聚体含量,用磁珠法测定纤维蛋白原含量。主要观察指标:观察各组D-二聚体和纤维蛋白原的含量。结果:参加试验的435例均进入结果分析。老年对照组的D-二聚体含量和纤维蛋白原含量[(0.91±0.51)mg/L,(3.69±1.25)g/L]高于中青年对照组[(0.48±0.15)mg/L,(3.12±0.76)g/L],t=2.39～2.66,P<0.05。老年冠心病组,老年脑血管病组的D-二聚体含量[(1.35±0.72)mg/L,(1.16±0.98)mg/L]和纤维蛋白原含量[(4.16±1.30)mg/L,(4.05±1.98)g/L]显著高于老年对照组和中青年对照组,t=4.23～5.41,P<0.01。结论:与中青年对照组比较,老年人群体内D-二聚体及纤维蛋白原水平升高,而心脑血管疾病组的D-二聚体及纤维蛋白原水平升高则更显著。
BACKGROUND: Studies have shown that D-dimer and fibrinogen in plasma are closely related to the blood coagulation state before cardiovascular and cerebrovascular diseases. OBJECTIVE: To analyze the difference of plasma levels of prethrombotic markers and fibrinogen in elderly patients with cardio-cerebrovascular diseases and elderly and middle-aged healthy controls. Design: The patient as the object of observation, case analysis. Unit: a Military General Hospital cadre ward. PARTICIPANTS: 153 patients with coronary heart disease and 116 patients with cerebrovascular disease were admitted to the Second Cadre Ward of People’s Liberation Army Shenyang Military Region General Hospital from October 2000 to March 2002, both of whom were over 60 years old. Another 68 cases of <60-year-old healthy people who chose to come to our hospital for physical examination were young and middle-aged control group, and 98 cases of ≥60-year-old healthy were elderly control group. Methods: On the second day after admission, venous blood was taken from 2 mL (taking aspirin for 4 days and taking blood for 4 days). The plasma was stained with STA-Compat automatic coagulation analyzer and kit supplied by Stago Company of France. Dimer content, using magnetic beads method for determination of fibrinogen content. MAIN OUTCOME MEASURES: The contents of D-dimer and fibrinogen in each group were observed. Results: All the 435 patients who participated in the trial entered the result analysis. The levels of D-dimer and fibrinogen in the elderly control group [(0.91 ± 0.51) mg / L, (3.69 ± 1.25) g / L] were higher than those in the young and middle-aged control group [(0.48 ± 0.15) mg / (3.12 ± 0.76) g / L], t = 2.39 ~ 2.66, P <0.05. (1.35 ± 0.72) mg / L, (1.16 ± 0.98) mg / L] and fibrinogen content [(4.16 ± 1.30) mg / L in elderly patients with coronary heart disease and elderly patients with cerebrovascular disease, , (4.05 ± 1.98) g / L] were significantly higher than those in control group and middle-aged control group (t = 4.23-5.41, P <0.01). Conclusion: Compared with the young and middle-aged control group, the levels of D-dimer and fibrinogen in the elderly are increased, but the levels of D-dimer and fibrinogen in the cardiovascular and cerebrovascular diseases group are more significant.