不稳定型心绞痛患者Latex法检测血浆D-二聚体的临床意义

On clinical significance of determination of D-dimer in plasma with monoclonal antibody coated latex particles in patients with unstable angina

目的探讨血浆D-二聚体（D－dimer）定性检测及血浆纤维蛋白原（Fbg）水平对评价不稳定型心绞痛（UA）患者凝血-纤溶活性的临床意义。方法本文对58例UA患者用Latex法作D－dimer定性测定，其结果与患者的Fbg水平及各对照组的结果作对比分析。结果D－dimer阳性率在UA组及急性心肌梗死（AMI）组均高于健康对照组及稳定型心绞痛（SA ）组，P＜0．01。UA患者D－dimer阳性组的Fbg水平高于阴性组，P＜0．01，有极其显著的差异。结论D－dimer阳性率在UA组及AMI组明显增高。UA患者D－dimer阳性，Fbg增高应考虑有高凝-继发纤溶活性增强的可能，是血栓形成的标记。D-dimer阴性，Fbg增高的UA患者不排除高凝-低纤溶的可能。D－dimer阴性，Fbg水平不高的UA患者应考虑非血栓的因素为其主要的病因。

Objective To study the clinical significance of the D- dimer and fibrinogen (Fbg)levels in plasma for assessing the plasma coagulation and secondary fibrinolgtic activity in patients with unstable angina (UA). Methods To determine the D-dimer with monoclonal antibody coated Latex particles for 58 UA Pahents, and analyse the Fbg levels, comparing with the cases of acute myocardial infartion (AMI) and the controls. Results The positive rates of D - dimer in UA group and AMI group were higher than that in the controls (P <0.01). The Fbg levels in D - dimer positive UA group was significantly higher than in the D- dimer negative and stable angina (SA) groups (P < 0.01). Conclusions The peitive at Of D- dimeris sinificanily higher in the UA gIDuP and AMIgroup. In the UA patientS if D - fors is peihveand Fbg is higher, showing a possibility of incin the achvity of higher coagulation - secontw fibrinolysis, they should be an index of sis.And the secondals fibrinolytic activity should beweaked in those with negative D - dimer and increased Fhg level. In UA patientS with negative D fors and lower levels of ac their UA may causedby other mechedsm rather than thrombosis.[