血浆D-二聚体、C-反应蛋白水平及血气分析检测在血栓性肺栓塞临床分型中的应用  

Application of plasma D-dimer、C-reactive protein level and blood gas analysis in clinical classification of pulmonary thrombembolism

作　　者：陈芳建[1] 王李华[2] 祝超霞 朱庆文[1] 陆炜[2] 

机构地区：[1]浙江省衢州市人民医院检验科,浙江衢州324000 [2]浙江省衢州市人民医院血管外科,浙江衢州324000 [3]温州医科大学检验医学院,浙江温州325035

出　　处：《中国现代医生》2015年第36期131-134,F0003,共5页China Modern Doctor

基　　金：浙江省公益技术应用研究项目(2014C34SA900003)

摘　　要：目的 探讨血浆D-二聚体（D-D）、C-反应蛋白（CRP）水平与血气分析检测在血栓性肺栓塞（PTE）临床分型中的应用,为临床分型和治疗提供参考。方法 收集我院2012年6月-2014年9月96例确诊为PTE的住院患者,根据栓塞面积分为两组：大面积栓塞组（A组）42例,非大面积栓塞组（B组）54例;同期健康体检33例作为对照租,分析三组的血浆D-D、CRP和血气分析结果 。结果 A、B组和正常对照组比较：两组中血浆D-D和CRP水平明显高于对照组,PO_2明显低于对照组,且B组中PCO2也明显低于对照组,差异有统计学意义（P〈0.05）;A组与B组比较：A组中血浆D-D、CRP、PCO2较B组升高,PO_2较B组下降,差异有统计学意义（P〈0.05）;三项检测指标对PTE的敏感性随栓塞面积增加而增高;三项指标联合检测对诊断大面积肺栓塞的特异度明显高于任意指标单项检测。结论 血浆D-D、CRP联合血气分析检测对肺栓塞临床分型具有较大参考价值,对及时给予适当的治疗及制定诊疗方案具有很好的应用价值。Objective To investigate the application of plasma D-dimer（D-D）,C-reactive protein（CRP） and blood gas analysis in clinical classification of pulmonary thrombembolism（PTE） and provide reference for clinical classification and treatment.Methods A total of 96 cases of PTE inpatients in our hospital admitted from June 2012 to September2014 were divided into two groups according to the embolism area;group A-massive PTE（n=42） and group Bnon-massive PTE（n=54）.Another 33 physical examination cases in corresponding period were enrolled as the control group.Plasma D-D、CRP level and blood gas analysis were retrospectively analyzed.Results Plasma D-D and CRP level of group A and B were significantly higher than that of control group and PO2 was significantly lower than that of control group（P〈0.05）.In addition,PCO2 of group B was significantly lower than control group（P〈0.05）.Compared with group B,plasma D-D,CRP and PCO2 of group A were increased obviously,PO_2 was significantly decreased（P〈0.05）.The sensitivity of the three detection indexes were proportional to the embolization area.The speci ficity of combined detection of plasma D-D,CRP level and blood gas analysis was significantly higher than any single assay to the diagnosis of massive PTE.Conclusion Combined detection of plasma D-D,CRP and blood gas analysis have a great reference value for the clinical classification and good applications for the appropriate treatment and diagnosis and treatment scheme of PTE timely.

关 键 词：血栓性肺栓塞 D-二聚体 C-反应蛋白 血气分析 

分 类 号：R563.5[医药卫生—呼吸系统]