D-二聚体在急性胰腺炎患者中的预测作用

The Predictive Effect of D-dimer In Acute Pancreatitis

目的探讨D-二聚体在重症急性胰腺炎时的变化。方法共检测收入本院的126例患者,其中38例重症急性胰腺炎患者及88例轻症急性胰腺炎患者,160名健康体检者作为对照,测定血浆D-二聚体。记录患者入院后第1天各项实验室指标、48hRanson和24hAPACHEⅡ评分,了解D-二聚体含量与各项实验室指标、评分是否存在相关性。结果 D-二聚体对照组分别为(0.41±0.02)mg/L,轻症急性胰腺炎组为(0.74±0.14)mg/L,二者差异均统计学意义(P<0.05),重症急性胰腺炎组为(2.69±0.63)mg/L,与对照组及轻症急性胰腺炎组比较差异均有统计学意义(P<0.05)。AP患者血浆D-二聚体水平与48h Ranson评分、24h APACHEⅡ评分均呈显著正相关(r值分别为0.739和0.705,P<0.01)结论 AP患者血浆D-二聚体升高,D-二聚体含量和胰腺炎病情严重程度明显相关。

Objective To explore the clinical value of the concentration of plasma D-dimer in patients with severe acute pancreatitis. Methods Plasma concentration of the D-dimer was measured in 88 patients with mild acute pancreatitis （MAP） , 38 patients with severe acute pancreatitis （SAP） and 160 normal people as the control group. The results of routine laboratory tests, 48hRanson and 24h APACHE II scores were all recorded. We attempted to find a relationship between the D-dimer level and the results of 48hRanson scores, 24h APACHE scores II. Results Compared with the control group, plasma concentration of the D-dimer was much higher in MAP （P〈0.05） and SAP patients （P〈0.05） . The D-dimer level in the SAP group was higher than the MAP group （P〈0.05） . The rise in the D-dimer level was directly related to the 48h Ranson and 24h APACHE scores II （I＂=0.739 and 0.705, P〈0.01 ） . Conclusion Plasma coiacentration of the D-dimer rises in AP patients, the D-dimer level is related to the disease severity.