D-二聚体在急性胰腺炎中的特点  

Characteristics of plasma D-dimer level in acute pancreatitis

作　　者：张卫平[1] 吴银亚[2] 张超杰[1] 向正国[2] 李科军[2] 陈旭峰[2] 

机构地区：[1]解放军101医院普外科,江苏省无锡市214000 [2]解放军101医院消化内科,江苏省无锡市214000

出　　处：《世界华人消化杂志》2017年第12期1056-1060,共5页World Chinese Journal of Digestology

摘　　要：目的回顾性分析无锡101医院近2年来急性胰腺炎(acute pancreatitis,AP)患者D-二聚体(D-dimer,DD)值与临床特点,探讨DD与病情严重程度的相关性,为其临床研究提供参考.方法收集解放军101医院2014-04-01/2016-04-01AP患者,记载临床特点,根据病情分为轻、中、重3组,分析AP患者DD水平、住院时间、费用、Rason评分及CT严重度指数(CT severity index,CTSI)评分.结果符合要求者共172例,其中轻度急性胰腺炎(mild acute pancreatitis,MAP)组111例,中度重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)组52例,重症急性胰腺炎(severe acute pancreatitis,SAP)组9例.DD水平在MSAP、SAP组中明显高于MAP组,有统计学意义(P<0.01),但MSAP组对比SAP组无明显差异;另外住院天数及费用3组间呈递增,有统计学差异.将3组患者中年龄<60岁分为中青年组,年龄≥60岁为老年组,其中SAP、MSAP两组中老年患者明显高于中青年患者(P<0.05),SAP组中未见明显差异;老年患者中MAP、MSAP、SAP 3组DD水平均无统计学差异.DD与住院天数、费用、CTSI分级、Ranson评分系统的相关系数分别为0.429、0.436、0.402、0.447,呈正相关.结论 DD在AP患者显著增高,中、重度组尤为明显,与住院时间、费用、评分呈正相关,本研究表明血浆DD体对AP严重程度的早期判断有一定的意义,但对于老年AP患者以及对MSAP和SAP患者的判断效果欠佳.To analyze the relationship between clinical characteristics and plasma D-dimer （DD） level in patients with acute pancreatitis （AP） diagnosed over the past 2 years at the 101 Hospital of PLA. METHODS From 2014 to 2016, 152 patients diagnosed with AP were divided into three groups according to the severity of illness： a mild acute pancreatitis （MAP） group （111 cases）, a moderately severe acute pancreatitis （MSAP） group （52 cases）, and a severe acute pancreatitis （SAP） group （9 cases）. The correlation of plasma level of D-dimer with Ranson and CTSI scores, length of stay, and hospitalization cost was analyzed. RESULTS Plasma level of D-dimer was significantly higher in the MSAP and SAP groups than in the MAP group （P 〈 0.01）, but there was no significant difference between the MSAP and SAP groups. In addition, hospitalization days and cost differed significantly among the three groups （P 〈 0.01）. Plasma level of D-dimer was positively correlated with length of stay, hospitalization cost, Ranson score, and CTSI score （r = 0.429, 0.436, 0.402, 0.447）.CONCLUSION Plasma level of D-dimer increases with the increase in the severity of AP, and it positively correlates with hospitalization time, cost, Ranson score, and CTSI score. Plasma level of D-dimer may be used for early evaluation ofthe severity of AP.

关 键 词：急性胰腺炎 D-二聚体 预测 

分 类 号：R576[医药卫生—消化系统]