老年人缺血性卒中与纤维蛋白原的关系。

R S Spada, G Toscano, S Chiarenza, S Di Mauro, F I I Cosentino, I Iero, B Lanuzza, M Tripodi, R Ferri
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引用次数: 14

摘要

衰老伴随着缺血性脑卒中患病率和发病率的显著增加。在老年人中,血浆纤维蛋白原水平随年龄的增长而增加,这与中风的发病率相似。我们研究的目的是评估老年人纤维蛋白原血浆水平的年龄相关性增加,并评估正常受试者和既往缺血性卒中伴脑前动脉粥样硬化患者之间存在的最终差异。本研究纳入80例连续入住我院老年科的住院患者(男41例,女39例)。患者组32例(男20例,女12例),年龄50-79岁,患有脑血管疾病,既往缺血性脑卒中发作1年以上。对照组48例,男21例,女27例,年龄50 ~ 79岁。对照组和患者组根据年龄又分为3个亚组:1组(50 ~ 59岁)、2组(60 ~ 69岁)和3组(70 ~ 79岁)。采用mann - whitney非参数检验进行统计比较。在正常对照中,轻微的年龄效应是明显的,因为只有第3组的纤维蛋白原水平明显高于第1组。相反,在缺血性脑卒中患者中,2组和1组之间的年龄效应已经很明显;当然,患者3组与患者1组的比较也有统计学上的显著差异。此外,2组和3组患者的纤维蛋白原水平与同龄对照组相比显著升高。我们的数据与文献中已有的数据一致,表明纤维蛋白原在正常衰老过程中随着年龄的变化而变化,在第1组和第3组之间纤维蛋白原增加19%。缺血性卒中患者比正常对照更早、更明显地显示出纤维蛋白原与年龄相关的增加。即使不可能知道纤维蛋白原升高是否是缺血性脑卒中的结果,我们也可以肯定,纤维蛋白原升高应该被视为老年人脑血管疾病的重要危险因素,值得治疗。
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Ischemic stroke and fibrinogen in the elderly.

Senescence is accompanied by an important increase in prevalence and incidence of ischemic stroke. The plasma level of fibrinogen tends to increase with age in the elderly similarly to the prevalence of stroke. The aim of our study was to evaluate the age-related increase in fibrinogen plasma level in the elderly and to assess the presence of eventual differences between normal subjects and patients with previous ischemic stroke associated with precerebral atherosclerosis. Eighty inpatients (41 males and 39 females), consecutively admitted to our Geriatric Unit, were included to this study. The patient group was formed 32 subjects (20 males and 12 females) aged 50-79 years, suffering from cerebrovascular disease with one or several previous ischemic stroke episodes, having occurred at least 1 year earlier. The control group consisted of 48 normal subjects (21 males and 27 females) aged 50-79 years. Both control and patient groups were subdivided into three subgroups, according to their age: Group 1 (50-59 years), Group 2 (60-69 years)and Group 3 (70-79 years). The statistical comparison was carried out by means of the Mann-Whithney nonparametric test. In normal controls, a mild age effect is evident because only Group 3 shows fibrinogen levels significantly higher than those of Group 1. On the contrary, in patients with ischemic stroke, an age effect is already evident between Group 2 and Group 1; of course, also the comparison between patient Group 3 and Group I shows a statistically significant difference. Moreover, the levels of fibrinogen were significantly increased in patient Group 2 and 3 when compared to those of their respective age-matched controls. Our data are in agreement with those already available in the literature and demonstrate that fibrinogen in normal aging changes with age and shows a 19 %increase between age Group 1 and Group 3. Patients with ischemic stroke show an earlier and more evident age-related increase in fibrinogen than normal controls. Even if it is not possible to know, if the increase in fibrinogen is a consequence or not of the ischemic stroke, we can affirm that certainly the increased levels of fibrinogen should be considered as an important risk factor in the elderly for cerebrovascular disease and deserve treatment.

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