血浆D二聚体和纤维蛋白原改变在肺部疾病中的临床意义

The clinical significance of the changes of plasma levels of D- dimer and Fibrinogen in patients with pulmonary diseases

目的探讨血浆D二聚体及纤维蛋白原水平在常见肺部疾病中的变化及临床意义。方法对156例住院治疗的肺炎、慢性阻塞性肺病、急性肺栓塞及肺癌患者血浆D二聚体、纤维蛋白原水平进行测定，并与对照组进行分析比较。结果4种不同肺部疾病患者血浆D二聚体及纤维蛋白原水平与对照组比较明显升高，肺炎患者的血浆D二聚体及纤维蛋白原水平低于其余3种肺部疾病，全部急性肺栓塞患者血浆D二聚体水平均超过正常参考标准。结论肺炎、慢性阻塞性肺病、肺癌、急性肺栓塞均可引发血浆D二聚体及纤维蛋白原升高，导致凝血机制异常，其中急性肺栓塞患者血浆D二聚体水平升高最明显，由此可作为急性肺栓塞阴性结果的排除指标。

Objective To investigate the clinical significance of the changes of plasma D - dimer and Fibrinogen in patients with common pulmonary diseases.Methods The plasma D- dimer and Fibrinogen levels were measured in 156 patients with pneumonia,chronic obstructive pulmonary disease,acute pulmonary embolism and lung cancer,and were compared with those of the healthy controls. Results The levels of D- dimer and Fibrinogen in patients with four different pulmonary diseases were apparently higher than those in control group（ P 〈 0.05）.The levels of D - dimer and Fibrinogen in patients with chronic o^truc- five pulmonary disease, acute pulmonary embolism and lung ~r were obviously higher than those in patients with pneumonia（ P 〈 0.05）, The levels of D - dimer in all patients with acute pulmonary embolism were higher than the regular reference stan- dard.Conclusion Pneumonia,chronic obstructive pulmonary disease, acute pulmonary embolism and lung cancer, all can arouse the raise of the levels of D- dimer and Fibfinogen in plasma,which may be related to the abnormal coagulation state.The diagnosis of acute pulmonary embolism in patients with normal level of D- dimer may be ruled out.