口腔颌面外科相关疾病血浆D-二聚休和FDP的联合检测及意义

Oral and Maxillofacial Surgery Related Diseases of Plasma D-dimer and FDP Joint Detection and Significance

目的 分析口腔颌面外科相关疾病与血浆D-二聚体（D D）和纤维蛋白（原）降解产物（FDP）的变化及临床意义.方法 采用免疫比浊法检测了口腔外科疾病患者444例,其中口腔外科间隙感染组（A组）30例、颌骨骨折组（B组）30例和颌面软组织损伤组（C组）31例、口腔良性肿瘤组（D组）113例、口腔恶性肿瘤组（E组）104例、恶性肿瘤术后组（F组）96例、恶性肿瘤术后转移组（G组）40例.50例健康体检者作为正常对照组.炎症外伤组为A组、B组和C组,肿瘤组为D组、E组、F组和G组.结果 血浆DD含量为：A组1.42±1.42 mg/L,B组2.30±2.83 mg/L,C组0.71±0.44 mg/L,D组0.56±0.67 mg/L,E组1.42±1.86 mg/L,F组0.72±0.67 mg/L,G组1.00±0.89 mg/L和正常对照组0.52±0.34mg/L.血浆FDP含量为：A组6.29±1.63 mg/L,B组7.16±3.41 mg/L,C组5.46±1.37 mg/L,D组5.34±1.47 mg/L,E组5.94±3.42 mg/L,F组5.18±1.36 mg/L,G组5.28±1.78 mg/L和正常对照组2.91±1.28 mg/L.A组、B组、C组、E组、F组和G组血浆DD水平与正常对照组比较差异有统计学意义（f=4.798～ 2.182,P均＜0.05）,D组血浆DD水平与正常对照组比较差异无统计学意义（P＞0.05）,A～G组血浆FDP水平与正常对照组比较差异均有统计学意义（f=10.272～ 6.053,P均＜0.05）.肿瘤各组血浆DD水平E组和G组高于D组（t=4.454, 2.894,P均＜0.05）,E组高于F组（t=3.621,P＜0.05）,G组高于F组（t=2.082,P＜0.05）;血浆FDP水平E组高于F组（t=2.095,P＜0.05）,肿瘤其他组两两比较差异均无统计学意义（P＞0.05）.炎症外伤组与正常对照组的组内方差分析结果比较差异有统计学意义（FDD=10.245和FFDP=34.204,P＜0.05）.肿瘤组和正常对照组的组内方差分析结果比较有统计学意义（FDD=10.568和FmP =17.487,P＜0.05）.结论 对口腔颌面间隙感染、颌骨骨折、颌面软组织损伤和口腔颌面肿瘤患者进行血浆DD和FDP的联合检测,可及时评估患者的凝血和纤溶的异常,同时为口腔颌面恶性肿瘤预后和疗效观察提供客观的参考数据.

Objective To analysis of oral and maxillofacial surgery related disease and plasma D dimer （D D） and fibrin degradation products （FDP） （original） of the change and clinical significance.Methods Immune turbidimetric method was used to detect the 444 cases of patients with oral surgery disease,including oral surgery between infection group （group A）,30 cases,jaw fracture group （group B） and 30 cases of jaw MianRuan tissueinjury group （C group） 31 cases,oral benign tumor group （group D） 113 cases,oral malignant tumor group （group E） 104 cases,malignant tumor surgery group （group F） in 96 cases,malignant tumor metastasis group （group G） after 40 cases.50 cases of healthy physical examination as normal control group.Inflammation,trauma group：group A and group B and group C,tumor group for the group D,E,F and G group.Results PlasmaDDcontent was：A：1.42±1.42 mg/L,B：2.30±2.83 mg/L,C：0.71±0.44 mg/L,D：0.56±0.67 mg/L,E：1.42±1.86 mg/L,F：0.72±0.67 mg/L,G：1.00±0.89 mg/L and normal control group：0.52±0.34 mg/L.PlasmaFDP content was：A：6.29±1.63 mg/L,B：7.16±3.41 mg/L,C：5.46±1.37 mg/L,D：5.34±1.47 mg/L,E：5.94± 3.42 mg/L,F：5.18±1.36 mg/L,G：5.28±1.78 mg/L and normal control group：2.91±1.28 mg/L.Group A and group B,C,E,F and G group plasma D-D levels and the normal control group difference was statistically significant （t＇=-4.798～ 2.182,P＜0.05）,group D level of plasma D-D there was no statistically significant difference with the normal control group （P＞0.05）,plasma FDP level A～G group and normal control group differences were statistically significant （t＇=-10.272～-6.053,P＜0.05）.Tumor groups of plasma D D level E group and G group is higher than the group D （t=-4.454,2.894,P＜ 0.05）,higher than that of group F group E （t=3.621,P＜0.05）,higher than in group G group F （t=2.082,P＜0.05）.Plasma FDP level higher than that of group F group E （t=2.095,P＜0.05）,tumor and comparing two other groups had no statistical significance （P＞0.05）.Inflammatory injury group and normal control group,the results of variance analysis comparison was statistically significant （FDD=10.245 and FFDP =34.204,P＜ 0.05）.Tumor group and normal control group,the results of variance analysis comparison was statistically significant （FDD=10.568 and FFDP=17.487,P＜0.05）.Conclusion Of oral and maxillofacial space infection,jaw bone fracture,jaw MianRuan tissue damage and oral and maxillofacial tumor patients with joint detection of plasma D D,FDP,can timely assessment of blood coagulation and fibrinolysis in patients with abnormal,at the same time for oral and maxillofacial malignant tumor prognosis and curative effect observation to provide objective reference data.