不同部位创伤骨折患者的D-二聚体水平及其临床意义

The significance of D-dimer in the diagnosis of patients with different parts of traumatic fracture

目的研究不同部位创伤骨折患者D-二聚体水平及其临床意义。方法将1 142例骨折患者作为观察对象,根据患者是否为急性创伤以及患者的骨折部位进行分组。于入院次日取空腹静脉血10 ml采用免疫比浊法对患者的D-二聚体和血清纤维蛋白降解产物水平进行测定。观察急性创伤与非急性创伤患者以及不同部位患者D-二聚体水平及其与患者血凝和血栓之间的关联。结果急性创伤组714例患者中,D-二聚体水平为469.24±61.53μg/L,阳性人数214例,占比29.99%;非急性创伤组428例患者中D-二聚体水平为124.36±14.35μg/L,阳性人数17例,占比3.97%。急性创伤患者的D二聚体水平以及阳性率显著高于非急性创伤患者(P<0.05);D-二聚体在上肢骨折、脊柱骨折、股骨骨折、胫腓骨骨折、足骨骨折、多骨折患者中阳性率分别为10.60%、20.91%、39.52%、87.73%、83.67%和59.77%。不同骨折部位患者D-二聚体水平与阳性率存在显著差异(P<0.0.5),以胫腓骨骨折患者和足骨骨折患者D-二聚体阳性率最高。结论急性和非急性创伤患者间,不同部位骨折患者间D-二聚体水平存在显著差异,其可以作为临床诊疗的重要参考指标。

Objective To evaluate the significance of D- dimer in the diagnosis of patients with different parts of traumatic fracture.Methods Plasma D- dieter in 1 142 trauma patients（ 1 142 cases; included 724 acute traumatic cases and 428 chronic traumatic cases） was analyzed with statistic retrospectively. Results 714 cases of acute trauma patients group,D- dimer mean was 469. 24 ± 61. 53 μg / L,the positive number of 214 cases,accounting for 29. 99%; non- acute trauma group 428 cases of patients D- dimer mean 124. 36 ± 14. 35 μg / L,the positive number of 17 cases,accounting for 3. 97%. D- dimer levels and positive rate of acute trauma patients was significantly higher than non- acute trauma patients（ P〈 0. 05）. D- dimer upper limb fractures,spine fractures,fractures,tibia and fibula fractures,foot fractures,multiple fractures in patients with positive rate was respectively 10. 60%,20. 91%,39. 52%,87. 73%,83. 67% and 59. 77%. Conclusion The D-dimer have huge significance of in the diagnosis of acute and non acute trauma patients with different parts of traumatic fracture.