中文摘要：

目的 探讨急性缺血性脑卒中患者入院时纤维蛋白原水平与出院结局不良的关系。方法 采用回顾性队列研究的方法,连续性纳入2009年5月31日至2013年5月31日在承德医学院附属医院神经内科住院的急性缺血性脑卒中患者,收集人口统计学及实验室检验资料。分别对符合纳入标准的研究对象出院时进行脑卒中量表评分（Modified Rankin＇s scale,MRs）（0分≤MRs≤2分为结局良好组,3分≤MRs≤6分为结局不良组）,并对结局不良组和结局良好组患者之间的基线资料进行比较。用四分位数法将入院时纤维蛋白原水平分为4组,分别为≤2.4g·L^-1、2.4~2.72g·L^-1、2.72~3.18g·L^-1及〉3.18g·L^-1组。用非条件Logistic回归分析入院时纤维蛋白原水平与急性缺血性脑卒中出院结局不良的关系。结果 对患者入院时纤维蛋白原水平四分位数分组后,第1~4组的结局不良发生率分别为24.25%、29.67%、33.00%及37.22%,各组之间的结局不良发生率比较差异有统计学意义。单因素分析后,以纤维蛋白原水平第1分位数组（≤2.4g·L^-1组）为参比组,第3、4分位数组相对于参比组的OR（95%CI）值分别为1.518（1.150~2.004）和1.896（1.442~2.494）,均P〈0.05。多因素调整后,以纤维蛋白原水平第1分位数组（≤2.4g·L^-1组）为参比组,第3、4分位数组相对于参比组的OR（95%CI）值分别为1.459（1.099~1.937）和1.683（1.271~2.230）,均P〈0.05。结论 急性缺血性脑卒中患者入院时的纤维蛋白原水平独立的与发生结局不良相关联,纤维蛋白原水平较高不利于急性缺血性脑卒中的预后。

英文摘要：

Objective To explore the relationship between fibrinogen level adverse clinical outcome among patients with acute ischemic stroke.Methods A non-concueernt cohort study was performed, continuity incorporated May 31, 2009 to May 31, 2013 in patients with acute ischemic stroke inpatients in a ffiliated Hospital of Chengde Medical College Department of internal medicine,collecting demographic and laboratory data.To accord with the stroke scale score criteria of the study hospital （Modified Rankin＇s scale, MRs） （0≤MRs≤2 points for the good outcome group, 3≤MRs≤6 points for the poor outcome group） , and compared between the poor outcome group and a good outcome of patients base line data.According to the quintile range of fibrinogen,patients were divided into four groups（≤2.4g·L^-1,2.4-2.72g·L^-1,2.72-3.18g·L^-1,〉3.18g·L^-1） .Logistic regression analysis was used. Results After fibrinogen quintiles,the proportion of poor outcome patients in each group were 24.25%, 29.67%, 33.00%,37.22%,the poor outcome between the groups there was a significant difference.After single factor analysis, compared with the first group,the OR（95%CI） of thrid,and forth group were 1.518（1.150-2.004） and 1.896（1.442-2.494）, respectively（P〈0.05）.After adjustment for multivariate,compared with the first group,the OR（95%CI） of thrid,and forth group were1.459（1.099-1.937） and 1.683（1.271-2.230）,respectively（P〈0.05）.Conclusion Patient with acute ischemic stroke of fibrinogen level independent and the occurrence of adverse outcomes associated with prognosis, higher levels of fibrinogen is harmful to stroke short-term outcome.