冠心病患者血浆D—二聚体水平测定及其临床意义

Clinical Significance of Determining Plasma Concentration of D-dimer in Patients With Coronary Heart Disease

目的 :探讨冠心病患者血浆D—二聚体含量和冠心病临床类型、病变程度的关系 ,以了解D—二聚体在冠心病的诊断和预后判断方面的意义。方法 :用酶联免疫吸附法检测 1 1例急性心肌梗死 (AMI)、1 5例稳定性心绞痛 (SA)、1 5例不稳定性心绞痛 (UA)、1 5例健康者血浆D—二聚体水平。结果 :AMI组、UA组、SA组患者血浆D—二聚体水平均高于正常对照组 (P均 <0 0 1 ) ,且AMI组明显高于UA组和SA组 (P均 <0 0 1 ) ,而SA与UA两组相比差异无显著性。结论 :冠心病患者存在凝血和纤溶功能异常 ,且异常程度与病情严重程度密切相关。至于UA与SA相比 ,血浆D—二聚体水平差异无显著性 。

Objective: Plasma levels of D-dimer, a degradation product of cross-linked fibrin, are elevated in the presence of thrombus. This paper was to study the relationship between plasma concentration of D-dimer and clinical classification and severity in patients with coronary heart disease.Methods: The concentrations of fibrin D-dimer from 41 patients' (AMI 11 cases, SA 15 cases and UA 15 cases) and 15 healthy adults' plasmas were determined with ELISA kits purchased from market. Results: (1)The level of plasma D-dimer in AMI, SA and UA patients was higher than that in normal subjects (P<0.01). (2)The level of plasma D-dimer in SA and UA group was significantly lower than that in AMI group (P<0.01). But rarely has the significant difference between SA and UA been found. Conclusion: The results indicated that the disturbance of patients coagulative and fibrinolytic systems, which is associated with the severity of coronary heart disease, is existed and suggested that the implication of no significant difference of D-dimer level between UA and SA patients be explored extensively later on.