D-二聚体水平在狼疮性肠炎诊断中的临床意义

Clinical significance of D-dimer level in patients with lupus enteritis

目的探讨D-二聚体水平在狼疮性肠炎患者诊断中的临床意义。方法89例系统性红斑狼疮（SLE）患者分为狼疮性肠炎组（10例）及狼疮无胃肠道病变组（79例），同期132例体检健康人群作为正常对照组。采用免疫比浊法检测不同组别血浆D-二聚体水平。结果与正常对照组比较，SLE患者D-二聚体水平明显升高[（0．14±0．24）mg／L比（o．40±0．21）吲L，P〈0．05]；狼疮性肠炎组D-二聚体水平为（o．81±0．45）mg／L，与正常对照组比较，差异有统计学意义（P〈0．05）；狼疮无胃肠道病变组D-二聚体水平为（O．19±0．20）mg／L，较正常对照组略有升高，但差异无统计学意义（P〉0．05）；狼疮无胃肠道病变组与狼疮性肠炎组D-二聚体水平比较，差异有统计学意义（P〈0．01）。79例无胃肠道病变组患者中，D-二聚体值升高者比例为43．0％（34／79），其中76．5％（26／34）集中于合并神经精神性狼疮、狼疮性肾炎、肺动脉高压、心功能不全等重要脏器损伤患者。结论D-二聚体水平在SLE患者中升高，与是否存在胃肠道病变如狼疮性肠炎相关.

Objective To investigate clinical significance of D-dimer level in patients with lupus enteritis. Methods Immunoturbidimetry assay was used to detect the D-dimer level of the systemic lupus erythematosus （SLE） patients who were at the early/active stage of the disease. The 89 SLE patients were classified into two groups： lupus enteritis group and non-gastrointestinal disease group. The 132 health people were as normal control group. Immunoturbidimetry assay was used to detect the D-dimer level of the SLE patients who were at the early/ active stage of the disease and control group and analyze the difference of D-dimer level between different groups. Results The mean value of D-dimer of 89 SLE patients was （0.40 ±0.21 ） mg/L, which significantly higher than that in the normal control group[ （0. 14 ±0. 24）mg/L] （P 〈0. 05） ; The mean value of D-dimer in lupus enteritis group was （0. 81 ± 0. 45 ）mg/L which was significantly higher than that in the normal control group （P 〈 0. 05 ）. Meanwhile, the mean value of non-gastrointestinal disease group was （0. 19 ± 0. 20） mg/L, which was higher than that in the normal control group, which had no statistical significance （ P 〉 0. 05） ; At the same time, the mean value of D-dimer from lupus enteritis group was higher than that from non-gastrointestinal disease group, which had statistical significance（P 〈 0.01 ）. Thirty-four cases （43.0%）had higher D-dimer value in 79 non-gastrointestinal disease patients, and 26 cases （76.5%） who had higher D-dimer value were vital organ involved such as neuropsychiatric lupus,lupus nephritis, pulmonary hypertension and cardia insufficiency. Conclusions The high D-dimer value is mainly in SLE patients who are sufferring from vital organ involved. The high D-dimer value is also related to gastrointestinal disease such as lupus enteritis.