常规实验室检查用于急性主动脉夹层早期诊断及预后的价值

目的观察常规实验室检查在急性主动脉夹层的早期诊断及预后中的意义。方法选取2012年1月1日至2015年5月31日收治的由计算机断层摄影血管造影术（CTA）确诊的主动脉夹层患者102例，根据发病时间分为A组（急性主动脉夹层）及B组（慢性主动脉夹层），所有患者均于入院后半小时内抽取肘静脉血，测量C反应蛋白（CRP）、载脂蛋白A（U）A—O）、白细胞总数（WBC）、中性粒细胞总数（N）、淋巴细胞总数（L）、D-二聚体（D—dimer）、肌酸激酶（CK）、肌酸激酶同工酶（CK—MB）、尿素氮（BUN）、肌酐（Cr）等，计算中性粒细胞与淋巴细胞比值（N几）。观察住院期间各项并发症，主要终点事件为死亡，次要终点事件包括：夹层复发或进展、心肌梗死及心包积液、脑血管意外、肾功能不全，截瘫。根据主要终点事件分为死亡组及未死亡组，分析与死亡相关的实验室结果。结果常规实验室检查中，A组CRP，LPA—O，WBC，N，N／L，D-二聚体，CK及CK—MB均显著高于B组；A组住院期间死亡率38．89％，显著高于B组2．08％（P（0．05）；其余并发症，如夹层复发或进展、肾功能不全、截瘫，A组高于B组，但二者问无显著统计学差异（P〉0．05）；与夹层死亡有关的实验室结果做Logistic回归分析，结果显示CRP及N／L比值与患者是否发生死亡更加相关。结论敏感性、特异性高的实验室检查在AAD的早期诊断及预后中意义重大。

Objective To observe the significance of routine laboratory examination in early diagnosis and prognosis of acute aortic dissection.Methods Selectes 102 cases of patients with aortic dissection in our hospital from January 1,2012 to may 31,2015, according to the time of onset,divided into A group （acute aortic dissection） and B group （chronic aortic dissection）oAll patients were collected as follows ： gender, age, history of hypertension, diabetes mellitus, coronary heart disease, smoking history, hospitalization days ,treatment strategies and prognosis.All patients were within half an hour after admission ,draw venous blood,measuring C-reactive protein （CRP）,lipoprotein a （LPA-O）,the total number of white blood cell （WBC） count,neutrophil （n） and total lymphocyte count （L） and D dimer,creatine kinase （CK）,creatine kinase isoenzyme （CK-MB）,blood urea nitrogen （BUN）,creatinine （CR） ,calculated neutrophil cell and lymphocyte ratio （n / L）.During the hospitalization were the complications,the primary end- point for death and secondary endpoints include：dissection recurrence or progression,myocardial infarction,and pericardia1 effusion, brain vascular accident,renal function incomplete paraplegia.According to the primary end point events were divided into death group and non death group,analysis of laboratory results related to death.Resuh There was no significant difference between the two groups.CRP,LPA-O,WBC,N,N/L,D-dimer.CK and CK-MB in A group is higher than B,there were statistically significant differences between the two;The death rate of A group was 38.89%,higher than that of B group 2.08%,and the difference be- tween the two groups was statistically significant,Other complications,Such as the recurrence or progression,renal insufficiency, paraplegia,A group was higher than B group,but there was no significant difference between the two;To use logistic regression analysis to analysis of the test results related to death of aortic dissection,The results showed that CRP and the ratio of N/L was more related to the death of patients.Conclusion To find high sensitivity and specificity of laboratory examination have Great sig- nificance in the early diagnosis and prognosis of AAD.