摘要
目的探讨血浆D-二聚体检测在急性肠系膜动脉缺血（AMAI）中的应用价值。方法对124例疑诊为AMAI急腹症患者进行前瞻性研究。疼痛发作24h内抽血检测D-二聚体、纤维蛋白原、活化部分凝血活酶时间、凝血酶原时间、凝血酶时间。用阳性似然比评价D-二聚体水平在诊断急性肠系膜动脉缺血中的价值。结果9例确诊为AMAI中,D-二聚体中位数为1.6（0.4-5.6）mg/L,明显高于39例炎性疾病患者（P〈0.01）,高于22例肠痉挛患者（P〈0.05）。D-二聚体水平〉1.5mg/L结合心房颤动、女性等临床特征,计算阳性似然比为14.9。急性肠系膜动脉缺血患者中无一例D-二聚体水平〈0.3mg/L。结论D-二聚体水平检测在急腹症诊断中对排除急性肠系膜动脉缺血性疾病有重要价值。
Objective To assess the diagnostic properties of the fibrinolytic marker D-dimer in acute mesenteric artery isehemia （AMAI）. Methods Patients with suspected acute mesenterie artery occlusion at presentation had blood samples taken within 24 h of the onset of the pain for analysis of D-dimer, plasma fibrinogen, activated partial thromboplastin time, prothrombin time and thrombin time. The value of D-dimer to diagnose mesenterie artery occlusion was assessed by means of likelihood ratios. Results Nine of 124 patients were diagnoaed as acute mesenterie artery occlusion. The median D-dimer concentration was 1.6 （ 0.4-5.6 ） mg/L, which was higher than that in 39 patients with inflammatory diseases （ P 〈 0.01 ） or in 22 patients with intestinal enterospasm （ P 〈 0.05 ）. The combination of a D-dimer level more than 1.5 mg/L,artrial fibrillation and female sex were calculated as the likelihood ratio 14.9 for evaluation of acute mesenterie artery occlusion. No patient with a D-dimer concentration of 0.3mg/L or less had acute mesenterie artery occlusion. Conclusion D-dimer testing may be useful for the exclusion of the patients with suspected acute mesenterie artery occlusion.
出处
《中国综合临床》
北大核心
2007年第6期530-532,共3页
Clinical Medicine of China
