血浆D-二聚体测定在深静脉血栓形成中的意义

Measuring of D-dimer in patients with deep venous thrombosis

目的：探讨血浆D-二聚体测定对深静脉血栓形成（DVT）诊断和疗效评估的意义及DVT患者临床危险因素。方法回顾性分析435例DVT患者的血浆D-二聚体水平，同时在体检人群中随机选择150例作为对照组，比较分析DVT患者中135例初诊时的危险因素。进一步监测其中的33例DVT患者治疗后1-3d、7-10d、15d的血浆D-二聚体变化情况。结果 DVT患者血浆D-二聚体水平与对照组相比有统计学差异（P=0.000），抗凝治疗的有效率为78.8%。治疗有效组DVT患者的血浆D-二聚体下降程度与无效组相比有统计学差异（P=0.005）。年龄＜40岁的DVT患者中手术和外伤是主要危险因素，而年龄≥40岁患者中肿瘤、内科疾病、中心静脉置管及长期卧床是其主要危险因素。结论血浆D-二聚体是DVT诊断及疗效评估的重要指标，DVT危险因素是其一级预防的依据。

Objective To investigate plasma D- dimer levels in patients with deep venous thrombosis （DVT）. Methods Plasma D- dimer levels were measured in 435 patients with DVT, and 150 healthy subjects （controls）. The clinical data and plas-ma D- dimer levels were retrospectively analyzed in 135 DVT patients and the D- dimer levels were monitored in 33 DVT patients during the anticoagulation therapy at different time points （at 1-3d, 7-10d and 15d）. Results Compared to healthy subjects, plasma D- dimer levels in DVT patients were significantly increased （P=0.000）. The overal effective rate of treatment was 78.8%, D- dimer levels in effective patientws was significantly decreased after treatment （P=0.005）. For patients aged〈40, surgery and trauma were major risk factors of DVT;for those aged≥40, medical diseases, cancer, placement of central venous catheter and long- term bed rest were major risk factors. Conclusion Measurement of plasma D- dimer levels is of value in diagnosis and monotoring of therapeutic effect for patients with deep vein thrombosis.