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首页> 外文期刊>Circulation journal >Higher levels of serum fibrin-monomer reflect hypercoagulable state and thrombus formation in the left atrial appendage in patients with acute ischemic stroke.
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Higher levels of serum fibrin-monomer reflect hypercoagulable state and thrombus formation in the left atrial appendage in patients with acute ischemic stroke.

机译：急性缺血性卒中患者的血清纤维蛋白单体水平较高反映左心耳的高凝状态和血栓形成。

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摘要

BACKGROUND: It is sometimes difficult to make a diagnosis of cardioembolic stroke in the stroke care unit, because of the splashing and vanishing of the intracardiac source of the emboli on transesophageal echocardiography. Serum fibrin-monomer (FM) is a new marker for coagulation activity that is useful for identifying older individuals at increased risk of ischemic stroke. METHODS AND RESULTS: Two hundred and four patients with acute ischemic stroke were examined for serum coagulation and fibrinolytic activity on admission, and underwent transesophageal echocardiography within 7 days of onset. Serum levels of FM was significantly higher in patients with left atrial appendage (LAA) thrombus formation (n=24) than in those with no thrombus (88+/-52 vs 14+/-9 microg/ml, p<0.0001). On multivariate logistic regression analysis, FM was an independent predictor for LAA thrombus (RR 2.975, 95% confidence interval 1.114 to 4.820, p=0.0214). In patients with LAA thrombus negative group, cases with LAA emptying flow velocity at atrial systole that was absent or smaller than at early diastole had significantly higher FM levels as compared to cases with larger velocity (42+/-12 vs 8+/-5 microg/ml, p<0.0001). CONCLUSION: Higher levels of serum FM reflect LAA flow pattern alterations and thrombus formation in patients with acute ischemic stroke.
机译：背景：由于在经食管超声心动图上栓塞的心内源飞溅和消失，有时在中风监护病房中难以诊断出心脏栓塞性中风。血清纤维蛋白单体（FM）是凝血活性的新标记，可用于识别缺血性卒中风险增加的老年个体。方法与结果：对204例急性缺血性卒中患者入院时的血凝和纤溶活性进行了检查，并在发病后7天内进行了食管超声心动图检查。左心耳（LAA）血栓形成患者（n = 24）的血清FM水平明显高于无血栓形成的患者（88 +/- 52 vs 14 +/- 9 microg / ml，p <0.0001）。在多因素logistic回归分析中，FM是LAA血栓的独立预测因子（RR 2.975，95％置信区间1.114至4.820，p = 0.0214）。在有LAA血栓阴性组的患者中，与没有较大风速的患者相比，没有或小于早期舒张期的左室收缩期LAA排空流速的患者具有较高的FM水平（42 +/- 12 vs 8 +/- 5微克/毫升，p <0.0001）。结论：较高的血清FM水平反映了急性缺血性中风患者的LAA流型改变和血栓形成。

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