血清D-二聚体浓度对急性肺栓塞患者近期预后的评估价值

Prognostic value of D-dimer in acute pulmonary embolism

目的探讨D-二聚体血清浓度在急性肺栓塞患者近期预后评估中的应用价值。方法选择2011年3月至2013年12月开封市中心医院收治的60例急性肺栓塞患者为研究对象，均经多层螺旋CT检查确诊，在入院检测其血清D-二聚体水平，并根据测定结果将60例患者分为高浓度组30例（血清浓度高于5000ng／L）和低浓度组30例（血清浓度低于4999ng/L），记录两组患者一般资料和主要辅助检查结果，进行危险分层，评估预后。结果高浓度组与低浓度组患者在年龄、性别、临床症状（呼吸困难、胸痛、晕厥）以及血气分析等方面比较差异未见统计学意义（P〉0．05）；高浓度组患者近期预后分层中高危比例（43．33％）明显高于低浓度组，差畀有统计学意义（P〈0．05）；高浓度组病死率（10．00％）也明显高于低浓度组，但差异未见统计学意义（P〉0．05）。结论对于急性肺栓塞患者来说，D-二聚体血清浓度的高低预示着临床预后效果，对预后判断具有重要价值。

Objective To investigate the clinical value of D-Dimer on acute pulmonary embolism. Methods Sixty patients with acute pulmonary embolism from March 2011 to December 2013 were select- ed, all were confirmed by muhisliee CT examination. The serum D dimer levels were detected when they were admitted in the hospital, and according to the results, they were divided into high concentration group （ 30 patients, serum concentration higher than 5000 ng/L） and low concentration group （30 patients, ser- um concentration below 4999 ng/L）. General information and the main auxiliary examination results of the two groups were recorded ; the risk stratification and assessment of prognosis were conducted. Results The general information, clinical symptoms （dyspnea, chest pain, syncope） and blood gas analysis in high con- centrations group and low concentrations group had no significant differences （P 〉 0. 05 ）. The high risk proportion of prognostic stratification proportion in high concentration patients （43.33%） was higher than that of the low dose group（P 〈0. 05） ; The mortality of high concentrations （10. 00% ） was also higher than that of the low dose group （ P 〉 0. 05 ）. Conclusions For patients with acute pulmonary embolism, the level of serum D-dimer indicates prognosis and has an important value on prognosis.