血浆D-二聚体在肝硬化并自发性细菌性腹膜炎患者中的临床意义

Clinical Significance of Plasma D-dimer in Patients with Liver Cirrhosis Complicated with Spontaneous Bacterial Peritonitis

背景:D-二聚体是纤溶过程中的一种降解产物,其异常反映了体内凝血和纤溶系统的过度激活,在感染等非血栓性疾病中明显增高。目的:探讨血浆D-二聚体在肝硬化并自发性细菌性腹膜炎患者中的临床意义。方法:选取32例肝硬化并自发性细菌性腹膜炎患者(A组)、64例肝硬化并单纯腹水患者(B组),以34名健康体检者作为对照(C组),采用免疫比浊法检测血浆D-二聚体水平,并分析肝硬化患者血浆D-二聚体水平与Child-Pugh评分的关系。结果:A组血浆D-二聚体水平高于B组和C组,差异有统计学意义(P<0.05)。A组、B组患者血浆D-二聚体水平与Child-Pugh评分均相关(r=0.388,r=0.250;P均<0.05)。结论:血浆D-二聚体应作为肝硬化患者,尤其是并发自发性细菌性腹膜炎患者的重要观察指标。

D-dimer is a degradation product of fibrinolytic process, its abnormality reflects excessive activation of coagulation and fibrinolysis system in vivo. D-dimer increases significantly in some non-thrombotic diseases, such as infection. Aims ： To investigate the clinical significance of plasma D-dimer in patients with liver cirrhosis complicated with spontaneous bacterial peritonitis. Methods： Thirty-two paitents with liver cirrhosis complicated with spontaneous bacterial peritonitis （group A） and 64 paitents with liver cirrhosis complicated with ascites （group B） were enrolled, and 34 healthy subjects were served as controls （group C ）. Plasma D-dimer level was detected by immunoturbidimetry. The association between plasma D-direct level and Child-Pugh score in patients with liver cirrhosis was analyzed. Results： Plasma D-dimer level in group A was significantly higher than that in group B and group C （ P 〈 0.05 ）. Plasma D-dimer level was positively correlated with Child-Pugh score in group A and group B （ r = 0. 388, r = 0. 250 ; P all 〈 0.05 ）. Conclusions： Plasma D- dimer level can be regarded as an important index for liver cirrhosis, especially in patients complicated with spontaneous bacterial peritonitis.