肺栓塞、慢性肺心病、肺部感染患者D-二聚体检测的临床意义  

The clinical significance of D-dimer measuring to pulmonary embolism, chronic pulmonary heart disease and pulmonary infection

作　　者：王静[1] 陈耀平[1] 高中芳[1] 白永泽[1] 王贵杰[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2003年第8期463-465,共3页Ningxia Medical Journal

摘　　要：目的　探讨快速定量检测D -二聚体 (D -dimer,DD)在诊断肺栓塞 (Pulmonaryembolism ,PE)、慢性肺心病 (Chronicpulmonaryheartdisease,CPHD)、肺部感染 (Pulmonaryinfection ,PI)患者中的临床价值。 方法　检测 19例经临床确诊的PE患者 ,5 0例CPHD患者 [其中 38例患者在急性加重期 (Chronicpulmonaryheartdiseasea cutestage ,CPHDA)、12例患者在缓解期 (Chronicpulmonaryheartdiseaseremissionstage ,CPHDR) ],30例PI患者及2 0例健康人 (对照组 )的血浆DD含量。结果　与对照组比较PE组、CPHDA组及PI组的DD含量明显升高 ,有显著性差异 (P <0 .0 1、P <0 .0 1、P <0 .0 5 ) ;PE组与CPHD组、PI组比较DD含量也明显升高 ,有显著性差异 (P <0 .0 1、P<0 .0 1) ;CPHDA组与CPHDR组、PI组比较有显著性差异 (P <0 .0 5、P <0 .0 5 ) ;PI组与CPHDR比较有显著性差异 (P <0 .0 5 ) ;CPHDR组与对照组比较DD含量也有所升高 ,但无显著性差异 (P >0 .0 5 )。结论　PE、CPHDA以及PI患者的DD含量明显升高 ,说明纤溶系统紊乱 ,存在不同程度的继发性纤溶亢进 ,特别是PE患者。说明DD在诊断PE、判断CPHD以及PI的病程及预后中有一定的临床价值 ,尤其是PE的诊断 ,已作为首选指标。本方法的敏感性为 10 0 %,阴性预期值为 10 0 %,?Objectives To study the clinical value of Sysmex CA1500 Automated Blood Coagulation Analyzer measuring D-dimer for the patients of pulmonary embolism(PE),chronic pulmonary heart disease(CPHD)and pulmonary infection(PI).Methods Measuring the quantity of plasma D-dimer of 19 cases clinical confirmed pulmonary embolism patients,50 cases of chronic pulmonary heart disease patients[38 cases in acute stage(CPHDA),12 cases in remission stage(CPHDR)],30 cases pulmonary infection patients and 20 cases healthy group with contrast.Results Plasma DD level in PE group ,CPHDA group and PI group was significant higher than that in contrast group(P<0.01、P<0.01、 P<0.05); Plasma DD level in PE group was significant higher than that in CPHDA group and PI group (P<0.01、P<0.01); Plasma DD level in CPHDA group was significant higher than that in CPHDR group and PI group(P<0.05、P<0.05); Plasma DD level in PI group was significant higher than that in CPHDR group(P<0.05); Plasma DD level in CPHDR group was also higher than that in contrast group,but there were no significant differences(P>0.05).Conclusions Plasma DD is a specific degradation product of fibrous protein of there chain formed after degradation of cross-link fibrous protein. It is the specific index of the secondary sthenic of fibrinolysis. Plasma DD level in PE,CPHDA and PI group was significant elevated, as fibrinolysis system is disorder ,it is a difference degree of the secondary sthenic of fibrinolysis . especially in PE patient,it is show that the measuring of DD have a definite clinical value in diagnostic of PE and in the estimation of the course of disease of CPHD and PI and expect the prognosis. especially in PE it is the first diagnostic index. The test showed a sensitivity of 100%, a negative predictive value of 100%. It is worthy of popularizing to use.

关 键 词：肺栓塞 肺心病 肺部感染 D-二聚体 乳胶凝集法 

分 类 号：R446.6[医药卫生—诊断学]