D-二聚体与C反应蛋白对Stanford A型主动脉夹层动脉瘤患者术后远期预后的预测价值  

Predictive Value of D-dimer and C Reactive Protein for the Long-term Postoperative Prognosis in Patients with Type Stanford A Aortic Dissection Aneurysm

作　　者：屈冰[1] 张楠[1] 化召辉[1] 李震[1] QU Bing;ZHANG Nan;HUA Zhaohui(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2024年第2期327-330,共4页The Practical Journal of Cancer

摘　　要：目的分析D-二聚体(D-D)与C反应蛋白(CRP)在Stanford A型主动脉夹层动脉瘤(ADA)患者术后远期预后中的预测价值。方法选取76例胸痛患者为研究对象,所有患者均行心脏超声或主动脉CT血管成像检查,将45例Stanford A型ADA患者纳入观察组,均行手术治疗;非Stanford A型ADA的31例患者纳入对照组。对比2组发生胸痛72 h内的D-D与CRP水平。术后对观察组随访3年,按临床结局分成死亡组(n=10)与存活组(n=35),对比2组D-D与CRP水平;另绘制受试者工作曲线(ROC),分析D-D、CRP单独与联合预测Stanford A型ADA患者的远期预后临床价值。结果观察组的D-D[(1.31±0.35)mg/L]与CRP[(16.59±2.34)mg/L]水平高于对照组[(0.68±0.13)mg/L、(7.53±1.26)mg/L],差异有统计学意义(P<0.05);ADA患者中死亡组的D-D[(1.78±0.49)mg/L]与CRP[(30.46±4.77)mg/L]水平高于存活组[(1.03±0.26)mg/L、(13.59±2.36)mg/L],差异有统计学意义(P<0.05)。ROC结果显示,D-D与CRP联合检测预测Stanford A型ADA患者远期预后的曲线下面积(AUC)[0.909(95%CI:0.823~0.994)]高于D-D与CRP单独预测[0.806(95%CI:0.680~0.931)、0.840(95%CI:0.727~0.953)]。结论Stanford A型ADA患者血清内的D-D与CRP水平呈高表达,且表达水平越高,患者预后越差,两项指标联合可有效预测患者的远期预后,临床应用价值较高。Objective To analyze the predictive value of D-dimer(D-D)and C-reactive protein(CRP)in the long-term prognosis of patients with Stanford A Aortic dissection(ADA).Methods 76 patients with chest pain were selected as the study subjects.All patients underwent cardiac ultrasound or aortic CT angiography examination.45 Stanford A type ADA patients were included in the observation group and underwent surgical treatment;31 patients with non Stanford A type ADA were included in the control group.Compare the levels of D-D and CRP within 72 hours of chest pain between the 2 groups.After surgery,the observation group was followed up for 3 years and divided into the death group(n=10)and the survival group(n=35)based on clinical outcomes.D-D and CRP levels were compared between the 2 groups;Additionally,draw a receiver operating curve(ROC)to analyze the clinical value of D-D and CRP alone and in combination in predicting the long-term prognosis of Stanford A type ADA patients.Results The levels of D-D[(1.31±0.35)mg/L]and CRP[(16.59±2.34)mg/L]in the observation group were higher than those in the control group[(0.68±0.13)mg/L,(7.53±1.26)mg/L],with statistical significance(P<0.05);The levels of D-D[(1.78±0.49)mg/L]and CRP[(30.46±4.77)mg/L]in the death group of ADA patients were higher than those in the survival group[(1.03±0.26)mg/L,(13.59±2.36)mg/L],with statistical significance(P<0.05).The ROC results showed that the area under the curve(AUC)[0.909(95%CI:0.823~0.994)]predicted by the combined detection of D-D and CRP for long-term prognosis in Stanford A type ADA patients was higher than that predicted by D-D and CRP alone[0.806(95%CI:0.680~0.931),0.840(95%CI:0.727~0.953)].Conclusion The levels of D-D and CRP in the serum of Stanford A type ADA patients are highly expressed,and the higher the expression level,the worse the patient's prognosis.The combination of these 2 indicators can effectively predict the long-term prognosis of patients,and has high clinical application value.

关 键 词：主动脉夹层动脉瘤 D-二聚体 C反应蛋白 远期预后 预测价值 

分 类 号：R732.21[医药卫生—肿瘤]