浅析D-二聚体在急性主动脉夹层患者中早期辅助诊断的意义及对预后评估的影响

The significance of early diagnosis of D-dimer in patients with acute aortic dissection and its impact on prognosis

目的探讨D-二聚体对急性主动脉夹层(AAD)患者早期辅助诊断的意义及对预后评估的影响。方法选取2011年10月至2014年2月间60例在郑州大学第二附属医院心血管外科经直接的数字剪影血管造影(DSA)、磁共振血管造影(MRA)、CT血管造影(CTA)或经食管超声心动图(TEE)确诊的AAD患者作为AAD组,相同时间区间住院的48例确诊为急性冠脉综合征(ACS)患者作为对照组,所有患者在入院时抽取血液检测D-二聚体浓度,对数据作统计学分析。结果 D-二聚体浓度在AAD组患者明显高于ACS组(P<0.05);在AAD确诊病例中,死亡病例D-二聚体水平远远高于存活病例(P<0.05)。结论 D-二聚体作为AAD的早期检验学指标,其检测结果为阴性对于排除AAD的诊断有很大帮助,D-二聚体浓度的高低对患者预后的评估及病变的范围估算也有指导意义。

Objective To explore the early diagnosis significance and prognosis impact of D-dimer for acute aortic dissection （ AAD） .Methods 60 cases from October 2011 to February 2014 in the department of cardiovascular surgery of the Second Affiliated Hospital of Zhengzhou University were diagnosed as AAD through direct digital angiography （ DSA） , magnetic resonance angiography （ MRA） , CT angiography （ CTA） or transesophageal echocardiography （ TEE） . 48 hospitalized patients at the same time interval who were diagnosed with acute coronary syndrome （ ACS） were included as a control group.All patients took blood at the time of admission when D-dimer concentration was tested .Statistics were used for data analysis .Results D-dimer concentration in AAD group was significantly higher than in the ACS group （ P〈0.05）;In the medical diagnosis of AAD , D-dimer levels in deaths were much higher than in the survival patients （P〈0.05）.Conclusions D-dimer test, as the index of early AAD the negative test results for the diagnosis of AAD exclusion are of great help to assess the prognosis of patients with high and low concentrations of D -dimer and lesions range estimates are also instructive .