血浆D-二聚体与肺栓塞诊断的关系  

Relationship between plasma D-dimer level and diagnosis of pulmonary embolism

作　　者：黄鼎三[1,2] 范建忠[1,2] 蔡鹏威[1,2] 陈新敬[1,2] 林丽容[1,2] 

机构地区：[1]福建医科大学省立临床医学院 [2]福建省立医院心内科,福建福州350001

出　　处：《心血管康复医学杂志》2015年第5期505-507,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨临床表现、心电图SⅠQⅢTⅢ特征、血浆D-二聚体(DD)水平与肺栓塞(PE)诊断的关系。方法:回顾性分析我院2012年6月至2014年5月进行肺动脉CT血管成像(CTA)的212例住院患者的临床资料。根据肺动脉CTA检查结果,患者被分为PE组(56例)和无PE组(156例)。收集患者住院基本资料,包括临床表现、ECG特征及血浆DD水平,并在两组间进行比较。结果:与无PE组比较,PE组呼吸困难(44.87%比75%),长期卧床(3.85%比14.29%)患者比例显著升高,无临床表现比例显著降低(38.46%比3.57%),P均<0.01。PE组ECG具有SⅠQⅢTⅢ特征的患者比例显著高于无PE组(50%比23.08%),P<0.01。与无PE组比较,PE组血浆DD>10μg/ml比例显著升高(19.23%比32.14%),P<0.05。结论:临床症状有呼吸困难和/或长期卧床者,出现其他心肺疾患不能解释的临床表现时;ECG具有SⅠQⅢTⅢ特征;DD明显升高(>10μg/ml)者应考虑肺栓塞的可能性。Objective： To explore the relationship among clinical manifestations, SIQⅢTm feature of ECG, plasma level of D-dimer （DD） and diagnosis of pulmonary embolism （PE）. Methods： Clinical data of 212 inpatients, who received pulmonary CT angiography （CTA） in our hospital from Jun 2012 to May 2014, were retrospectively ana- lyzed. According to pulmonary CTA results, patients were divided into PE group （n = 56） and non-PE group （n= 156）. Basic hospitalization data, including clinical manifestations, ECG features and plasma DD level, were collect- ed and compared between two groups. Results： Compared with non-PE group, there were significant rise in percent- ages of dyspnea （44.87% vs. 75%） and prolonged bedridden time （3.85% vs. 14.29%）, significant reduction in percentage of no clinical manifestations （38.46% vs. 3.57%） in PE group, P〈0.01 all. Percentage of ECG SIQⅢTm feature in PE group was significantly higher than that of non-PE group （50% vs. 23.08% ）, P〈0.01. Compared with non-PE group, percentage of plasma DD〉10μg/ml significantly rose （19.23% vs. 32.14%） in PE group, P〈 0.05. Conclusion： Patients with dyspnea and/or prolonged bedridden time, that cannot be explained by other car- diopulmonary diseases, and SI SIQⅢTm feature of ECG; plasma DD level significant rising （〉10μg/ml） should be considered to be PE.

关 键 词：肺栓塞 心电描记术 呼吸困难 

分 类 号：R563.509[医药卫生—呼吸系统]