D-二聚体水平评价急性心肌梗死危险程度及对预后的预测  

D-dimer value for the degree of risk and prognosis of acute myocardial infarction

作　　者：唐小勇[1] 钟万芬[2] 

机构地区：[1]湖北襄阳市中心医院湖北文理学院附属医院检验科,湖北襄阳441021 [2]湖北襄阳市中心医院检验科,湖北襄阳441021

出　　处：《现代医学》2016年第5期697-701,共5页Modern Medical Journal

摘　　要：目的:分析D-二聚体对急性心肌梗死(AMI)危险程度及预后预测的价值。方法:选取我院2012年5月至2015年5月收治入院的AMI患者85例,以1.0μg·ml-1作为分界点,将所有患者分为D-二聚体升高组和D-二聚体正常组。对比两组患者的一般情况、血液流变学指标、超敏C-反应蛋白(hs-CRP)、B型钠尿肽(BNP)、左室射血分数(LVEF)及治疗后1个月内主要心脏不良事件(MACE)和出血发生率。分析D-二聚体和患者不良事件的相关性。结果:D-二聚体升高组的血沉、血浆黏度、全血黏度高切、全血黏度中切、全血黏度低切、红细胞压积、红细胞聚集指数、hs-CRP和BNP、治疗后1个月内MACE和出血发生率显著高于D-二聚体正常组,LVEF显著低于D-二聚体正常组(P<0.05)。D-二聚体和患者再次心肌梗死、再次血运重建、心脏死亡、少量出血和大量出血具有显著相关性(P<0.05)。结论:AMI患者血清D-二聚体水平对于其近期预后具有一定预测意义。Objective： To analyze the value of D-dimmer for the degree of risk and prognosis of acute myocardial infarction（ AMI）. Methods： 85 cases with AMI in our department from May 2012 to May 2015 were selected.With 1. 0 μg·ml- 1as the cut-off point,all the patients were divided into D-dimer increased group and D-dimer normal group. The general condition,blood rheology,hs- CRP,BNP,LVEF,major adverse cardiac events（ MACE） and the incidence of bleeding after treatment within 1 month were compared in two groups of patients. The correlation between D-dimer and adverse events was analyzed. Results： ESR,plasma viscosity,high shear whole blood viscosity,whole blood viscosity in shear,low shear whole blood viscosity,hematocrit,red blood cell aggregation index,hs-CRP and BNP,MACE and bleeding rates within one month in D-dimer increased group were significantly higher than those in D-dimer normal group,LVEF was significantly lower than D-dimer normal group（ P〈0. 05）. D-dimer significantly correlated with myocardial infarction again,repeat revascularization,cardiac death,bleeding and heavy bleeding（ P〈0. 05）. Conclusion： The serum D-dimer level in patients with AMI has some predictive value for its short-term prognosis.

关 键 词：D-二聚体 急性心肌梗死 预后 

分 类 号：R542.22[医药卫生—心血管疾病]