Serum D-Dimer in Lacunar Stroke

Muhammad Fakhrul Islam, M. N. Uddin, Md. Titu Miah
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Abstract

Background: Stroke is the third most common cause of death in the developed world as well as is the most common cause of severe physical disability. A good number of studies have shown elevated serum D-Dimer level in acute ischemic stroke. Approximately one quarter of ischemic strokes are caused by lacunar infarct. This study demonstrated serum D-Dimer in Lacunar Stroke. The purpose of the study to find out serum D-Dimer in Lacunar Stroke. Materials and methods: This cross-sectional study was conducted in Medicine Department, Dhaka Medical College, Dhaka on the patients with diagnosis of first ever acute lacunar Ischemic (LACI) stroke presented within 2 days of onset of symptoms. In this study, total 45 acute LACI cases irrespective of their gender were included and examined in presence of consultant physician, who were admitted from March 2014 to September 2014. Results: An overall male predominance with a male to female ratio was 2:1 with the mean (SD) age of the study population of lacunar stroke was 57.60 (12.68) years. At the distribution of common risk factors in this study, there were hypertension (n=26, 57%), smoking (n=18, 40%) Diabetes mellitus (n=14, 31.1%), dyslipidemia (n=12, 26.6%) and ischemic heart disease (n=9, 20. %). Accounting the focus point of our study, the mean (SD) value of serum D-Dimer was 0.37 (0.20) mg/L with gender difference in male and female [0.39 (0.20) mg/L Vs. 0.31 (0.19) mg/L]. A regression analysis was done to find the association of D-Dimer category group (Dependent variable) which were categorized as Normal range [D-Dimer level <0.5 mg/L (n=29)] and Increased level [D-Dimer level ³0.5 mg/L (n=16)] according to normal cutoff point of D-Dimer (<0.5 mg/L). It shows there was no statistically significant difference among normal and raised D-Dimer with gender, age, smoking, Tobacco, family history of CVD, hypertension, Diabetes mellitus, and dyslipidemia (p value > 0.05). But here, male and dyslipidemia patients were respectively 3.23 and 3.84 times more prone to develop increased level of D-Dimer, but it was statistically nonsignificant. Conclusion: In this study, it was found that serum D-Dimer was not significantly raised with Lacunar stoke patients. Though lacunar stroke is diagnosed specially by imaging methods, serum D-Dimer may play a role in diagnosis process to exclude from non-lacunar stoke. Chatt Maa Shi Hosp Med Coll J; Vol.21 (2); July 2022; Page 30-34
腔隙性脑卒中的血清d -二聚体
背景:中风是发达国家第三大常见死亡原因,也是造成严重身体残疾的最常见原因。大量研究表明急性缺血性脑卒中患者血清d -二聚体水平升高。大约四分之一的缺血性中风是由腔隙性梗死引起的。本研究证实了血清d -二聚体在腔隙性卒中中的作用。目的探讨腔隙性脑卒中患者血清d -二聚体的变化。材料与方法:本横断面研究在达卡医学院医学系对首次诊断为急性腔隙性缺血性中风(LACI)的患者在发病2天内进行。本研究纳入了2014年3月至2014年9月收治的45例急性LACI患者,不论其性别,均在咨询医师的陪同下进行检查。结果:腔隙性脑卒中研究人群总体以男性为主,男女比例为2:1,平均(SD)年龄为57.60(12.68)岁。在本研究的常见危险因素分布中,高血压(n=26, 57%)、吸烟(n=18, 40%)、糖尿病(n=14, 31.1%)、血脂异常(n=12, 26.6%)、缺血性心脏病(n=9, 20)。%)。作为我们研究的重点,血清d -二聚体的SD均值为0.37 (0.20)mg/L,男女差异明显[0.39 (0.20)mg/L Vs. 0.31 (0.19) mg/L]。回归分析d -二聚体类别组(因变量)与正常范围的相关性[d -二聚体水平0.05]。但在这里,男性和血脂异常患者d -二聚体水平升高的可能性分别是3.23倍和3.84倍,但无统计学意义。结论:本研究发现腔隙性卒中患者血清d -二聚体无明显升高。虽然腔隙性脑卒中是专门通过影像学诊断的,但血清d -二聚体可能在诊断过程中起到排除非腔隙性脑卒中的作用。上海医科大学医学院;月,(2);2022年7月;34页
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