血清D-二聚体水平预测急性心肌梗死患者预后的价值分析  

Value of serum D-dimer in evaluating the prognostic in patients with acute myocardial infarction

作　　者：秦艳波[1] 秦大鹏 王慧[1] QIN Yanbo;QIN Dapeng;WANG Hui(The Second People′s Hospital of Jiaozuo City,Jiaozuo 454000,Henan,China;The Tiantan Hospital of Jiyuan City,Jiaozuo 454000,Henan,China)

机构地区：[1]焦作市第二人民医院,河南省焦作市454000 [2]济源市天坛医院,河南省济源市459000

出　　处：《内科》2018年第5期747-749,811,共4页Internal Medicine

摘　　要：目的探讨血清D-二聚体(D-dimer)水平预测急性心梗(AMI)患者预后的价值。方法选取2014年1月至2015年12月在焦作市两三甲医院急诊科就诊的120例AMI患者作为研究对象。检测患者血清D-dimer、肌钙蛋白T(c Tn I)及氨基末端B型脑钠肽前体(NT-ProBNP)水平,根据D-dimer水平将患者分为低D-dimer组(≤0. 83 mg/L)和高D-dimer组(> 0. 83 mg/L),通过绘制Kaplan-Meier生存曲线比较分析两组患者的预后状况;对D-dimer水平与c Tn I或NT-ProBNP水平的关系进行Pearson相关分析;通过绘制ROC曲线评估D-dimer水平预测AMI患者预后的效能。结果高D-dimer组患者的1年生存率显著低于低D-dimer组,差异有统计学意义(P <0. 05); AMI患者血清D-dimer水平与c Tn I、NT-proBNP水平均呈正相关(r=0. 748,P=0. 000; r=0. 612,P=0. 000)。D-dimer水平预测AMI患者预后的ROC曲线下面积为0. 782,截断值为1. 223 mg/L,敏感性为65. 40%,特异性为66. 70%。结论 AMI患者血清D-dimer水平与c Tn I、NT-proBNP水平均呈正相关,对预测AMI患者的预后具有一定的价值。Objective To study the value of serum D-dimer level in evaluating the prognosis in patients with acute myocardial infarction(AMI).Methods 120 patients with AMI who treated in two hospitals of Jiaozuo city from January 2014 to December 2015 were selected.The levels of serum D-dimer,cardiac troponin I(cTnI)and N-terminal pro-brain natriuretie peptide(NT-ProBNP)in patients were detected.According to the level of D-dimer,the patients were divided into low D-dimer level group(≤0.83 mg/L)and high D-dimer level group(>0.83 mg/L).Kaplan-Meier survival curve was draw to compare the difference of prognosis between the two groups.Pearson regression was used to analyze the potential correlation between D-dimer and other two serum factors(cTnI and NT-ProBNP).Finally,ROC curve was draw to evaluate the value of serum D-dimer level in predicting the prognostic in patients with AMI.Results Kaplan-Meier survival curve showed that the 1-year survival rate of patients in the high D-dimer level group was significantly lower than that in the low D-dimer group(P<0.05).Pearson regression showed the positive correlation between D-dimer and cTnI,NT-ProBNP(r=0.748,P=0.000;r=0.612,P=0.000).The area under the ROC curve was 0.782,with the most appropriate cut-off value of D-dimer to predict the prognostic in patients with AMI was 1.223 mg/L(with sensitivity 65.40%,specificity 66.70%).Conclusion Serum D-dimer level was positively correlated with cTnI and NT-ProBNP levels in patients with AMI.Serum level of D-dimer had the potential value to predict the prognostic of patients with AMI.

关 键 词：急性心肌梗死 D-二聚体 预后 

分 类 号：R542.22[医药卫生—心血管疾病]