血浆D-二聚体测定在肝病和心脑血管疾病中的临床应用

Clinical application of plasma D-dimer in liver disease and cardiovascular and cerebrovascular disease

目的探讨D-二聚体(D-dimer)变化与疾病间的关系。方法采用CA-1500型全自动血液凝固仪检测4种疾病及治疗前后血浆中D-二聚体的含量变化。结果慢性肝炎(中、重度)、肝硬化者血浆D-二聚体水平较正常对照组升高(P<0.01),而慢性肝炎(轻度)增高不明显(P>0.05),而且不同临床分型肝炎患者之间D-二聚体含量有显著性差异(P<0.05),随着肝炎患者病情的加重,D-二聚体含量递增。同时,急性心肌梗死组和脑外伤组也较正常对照组高(P<0.05,P<0.01)。结论D-二聚体的检测不仅可以反映患者呈现不同程度的纤溶亢进,而且是一项鉴别原发性纤溶和继发性纤溶以及监测溶栓治疗的有价值的指标,同时也可以作为肝炎病情轻重及预后判断的指标。

Objective To investigate the relationship of D - dimer in blood plasma and disease. Methods Detected content variation of D - dimer in blood plasma in liver disease, cardiovascular and cerebrovascular disease with CA- 1500 automated coagulation analyzer. Results D - dimer level in blood plasma in the groups of chronic hepatitis B （moderate, severe） and liver cirrhosis were higher than that in the group of healthy control（ P〈0.01） ;Slight chronic hepatitis B had no apparent increase in D- dimer level. Furthermore different clinical genotype of HBV infection sufferer has significant difference（ P 〈0.05） ;With the HBV infection sufferer state aggravate, content of D- dimer in these sufferer increase by degrees; D- dimer level in the groups of acute myocardial infarction and brain trauma were also higher than that in the group of healthy control （ P 〈 0.05, P 〈 0.01 ） ; Conclusion Detection of D- dimer content reflects sufferer present different degrees of fibrinolysis sthenic; And as a valuable index to judge HBV infection degree or prognosis and to distinguish primary fibrinolysis, secondary fibrinolysis or to observe treatment for dissolve embolism.