急性肺栓塞感染患者动脉血气联合D-二聚体的临床应用评价  

Clinical value of arterial blood gas combined with D-dimer in diagnosis of acute pulmonary embolism patients complicated with infections

作　　者：梁彩霞[1,2] 梁永锋[1,2] 雷向阳[1,2] 丘新才[1,2] 

机构地区：[1]南方医科大学附属南海医院 [2]佛山市南海区人民医院呼吸内科,广东佛山528200

出　　处：《中华医院感染学杂志》2014年第18期4495-4497,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81143700)

摘　　要：目的分析动脉血气(ABG)联合D-二聚体(DD)在急性肺栓塞(APE)合并感染患者的诊断价值。方法选取2010年5月-2012年5月收治的193例APE患者,按照其感染情况分为感染组及未感染组,对比两组患者ABG及DD检测结果。结果 193例APE患者共检出27例合并感染,感染率14.0%;感染组pH值、PaO2及P(A-a)O2均显著低于未感染组,其PaCO2高于未感染组,两组比较差异有统计学意义(P<0.05);感染组患者DD定量测定结果为(1830.9±974.6)μg/L,未感染组患者测定结果为(1527.8±835.2)μg/L,感染组患者DD检测结果显著高于未感染组;感染组患者治疗后pH值、PaO2及P(A-a)O2均显著上升,其PaCO2、DD含量显著下降,两组比较差异有统计学意义(P<0.05)。结论 ABG联合DD能够及时反应APE患者合并感染的发生,可有效指导临床判断及用药,是改善患者预后、保证其生存质量的良好监测方案,值得临床推广应用。OBJECTIVE To analyze the value of arterial blood gas （ABG） combined with D-dimer in diagnosis of a-cute pulmonary embolism （APE） patients complicated with infections .METHODS A total of 193 APE patients who were treated from May 2010 to May 2012 were enrolled in the study and divided into the infection group and the non-infection group according to the status of infections ,then the results of detection of ABG and D-dimer were observed and compared .RESULTS Of the 193 APE patients ,27 cases were complicated with infections ,with the infection rate of 14 .0% ;the pH value ,PaO2 ,and P（A-a）O2 of the infection group were significantly lower than those of the non-infection group ,while the PaCO2 of the infection group was higher than that of the non-infection group ,and there was significant difference between the two groups （P＆lt;0 .05） .The level of D-dimer of the infec-tion group was （1830 .9 ± 974 .6）μg/L ,significantly higher than （1527 .8 ± 835 .2）μg/L of the non-infection group .After the treatment ,the pH value ,PaO2 ,and P（A-a）O2 of the infection group were remarkably elevated , while the contents of PaCO2 and D-dimer were significantly decreased ,and there was significant difference between the two groups （P＆lt;0 .05） .CONCLUSION ABG combined with D-dimer may contribute to the timely diagnosis of the APE patients complicated with infections and guide the clinical use of antibiotics ;it is a good surveillance pro-gram to improve the prognosis of the patients and ensure the quality of life and is worthy to be promoted in the hospital .

关 键 词：动脉血气 D-二聚体 急性肺栓塞 感染 

分 类 号：R181.32[医药卫生—流行病学]