D-二聚体联合纤维蛋白(原)降解产物检测判断脑出血患者预后的临床价值

The Value of D-dimer and FDP Detection in Prognostic Judgment of Patients with Cerebral Hemorrhage

目的探讨D-二聚体联合纤维蛋白(原)降解产物(FDP)检测评估脑出血患者预后的临床价值。方法选取医院2016年1月至2017年12月收治的脑出血患者100例,根据CT影像估算的颅内出血量分为大量出血组(出血量≥30 ml)与小量出血组(出血量<30 ml),选取同一时期健康者88名作为对照组,检测3组不同时间段血浆D-二聚体与FDP水平的变化,分析其与患者病情的关系。结果与对照组比较,大量出血组及小量出血组的D-二聚体与FDP水平均升高,并分别持续增高至入院后第5天(小量出血组)和第7天(大量出血组);小量出血组的D-二聚体及FDP水平低于大量出血组,差异有统计学意义(P<0.05);Spearman分析发现脑出血患者的颅内出血量与血浆D-二聚体和FDP水平呈正相关;另外,D-二聚体与FDP联合检测对脑出血诊断的敏感性高于单独检测。结论脑出血患者的D-二聚体与FDP水平与患者的出血量有关,两者联合检测对病情的评估有重要价值。

Objective To explore the clinical value of D-dimer combined with fibrinogen degradation products(FDP)in evaluating the prognosis of patients with cerebral hemorrhage.Methods A total of 100 patients with cerebral hemorrhage were selected from January 2016 to December 2017.According to the amount of intracranial hemorrhage estimated by CT images,the patients were divided into two groups:massive hemorrhage group(bleeding volume≥30 ml)and small hemorrhage group(bleeding volume<30 ml).88 healthy subjects in the same period were selected as control.The plasma levels of D-dimer and FDP in three groups were detected.The relationship between the detected results and the prognosis of patients were analyzed.Results Higher expression of D-dimer and FDP were showed in the patients with cerebral hemorrhage when compared with the healthy controls,and their expression constantly rising until 5 days(small hemorrhage group)and 7 days(massive hemorrhage group)after admission.The levels of D-dimer and FDP in the small hemorrhage group were significantly lower than those in the massive hemorrhage group.Spearman analysis showed that the volume of intracranial hemorrhage was positively correlated with the plasma levels of D-dimer and FDP in patients with cerebral hemorrhage.In addition,the combined detection of D-dimer and FDP had higher sensitivity in the diagnosis of cerebral hemorrhage than that of single detection.Conclusion The levels of D-dimer and FDP in patients with cerebral hemorrhage are related to the amount of bleeding,the combined detection of them is of great value in the evaluation of the condition of patients with cerebral hemorrhage.