Abstract: Objective To investigate the serum fibrin monomer level and its clinical significance in maintenance hemodialysis (MHD) patients. Methods Blood coagulation factors including prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT), fibrin degradation products including fibrinogen degradation product (FDP), D dimmer (DDI) and fibrin monomer (FM), and biochemistry indices including triacylglycerol (TG), cholesterol (TC), high density lipoprotein cholesterol (HDL) and low density lipoprotein cholesterol (LDL) were assayed in MHD patients with and without cerebral infarction, and normal controls. Cardiac functional grading was performed according to the classification standards from New York Heart Association. Results There were obvious differences in TG, TC, HDL, and LDL between MHD patients without cerebral infarction and normal controls and between MHD patients with cerebral infarction
and normal controls (For comparison between MHD patients without cerebral infarction and normal controls: LSD-t=9.701, P＜0.001 for TG; LSD-t=5.779, P＜0.001 for TC; LSD-t=4.742, P＜0.001 for HD; LSDt= 3.152, P＜0.001 for LDL. For comparison between MHD patients with cerebral infarction and normal controls: LSD-t=9.791, P＜0.001 for TG; LSD-t=13.509, P＜0.001 for TC; LSD-t=5.251, P＜0.001 for HDL; LSD-t=3.152, P＜0.001 for LDL). There were no statistical differences in TT, PT and APTT, but obvious differences in FDP, DDI and FM between MHD patients without cerebral infarction and normal controls and between patients with cerebral infarction and normal controls (For comparison between MHD patients without cerebral infarction and normal controls: LSD-t=8.524, P＜0.001 for FDP; LSD-t=16.269, P＜0.001 for DDI; LSD-t=31.144, P＜0.001 for FM. For comparison between MHD patients with cerebral infarction and normal controls: LSD-t=49.621, P＜0.001 for FDP; LSD-t=16.757, P＜0.001 for DDI; LSD-t=46.445, P＜0.001 for FM). There were no statistical differences in TG, TC, HDL, LDL, FDP and DDI, but significant difference in FM (LSD-t=15.017, P＜0.001) between patients with cerebral infarction and those without cerebral infarction. There was significant difference in FM between MHD patients without cerebral infarction with cardiac function I- II grades and those with cardiac function III-IV grades (t=16.097, P＜0.001) and between MHD patients with cerebral infarction with cardiac function I-II grades and those with cardiac function III-IV grades (t=19.769, P＜0.001). Conclusion FM level may be a sensitive and accurate marker for the diagnosis of cerebral infarction in MHD patients.

Key words: Maintenance Hemodialysis, cerebral infarction, Fibrin Monomer