D-二聚体、血流变学指标对结缔组织病患者诊疗价值研究

The Value of D-dimer and Changes of Blood Rheology Index in the Diagnosis of Connective Tissue Disease

目的:探讨分析结缔组织病合并多器官损害患者D-二聚体(DD)、血流变学指标(血浆纤维蛋白原/血浆纤维蛋白降解产物FDP、全血黏度、血浆黏度)水平及指标变化对结缔组织病合并多器官损害患者病情活动期的诊疗价值。方法:本研究共纳入120例患者,其中活动组患者60例,病情缓解组患者60例,分别测定二组患者DD、血流变学指标水平,并采用t检验、灵敏度与特异度进行统计学分析与描述。结果:与缓解组比较,活动组DD、纤维蛋白降解产物(FDP)、全血黏度、血浆黏度、γ球蛋白、补体C4、ESR均具有统计学差异(P<0.01),补体C3组间差异也具有统计学意义(P<0.05)。各指标对于疾病活动性诊断的准确性,其DD>FDP>补体C3、C4>γ-球蛋白>血浆黏度>全血黏度>ESR。结论:结缔组织病合并多器官损害患者,其纤溶水平、微循环状态与疾病活动密切相关。

Objective： To analyze the levels of D-dimer （DD）, blood rheology indexes （fibrinogen/plasma fibrin degradation prod- ucts （FDP）, whole blood viscosity （1/S） and plasma viscosity）, and to explore the value of D-dirner and changes of blood rheology indexes in the diagnosis of connective tissue disease with multiple organ damage. Methods： The study included 120 patients, 60 cases in active group, 60 cases in remission group. The levels of DD, FDP, whole blood viscosity and plasma viscosity were detected, and were statistically analyzed using t-test. The sensitivity and specificity were also analyzed. Results： Compared with the remission group, the levels of DD, FDP, whole blood viscosity, plasma viscosity, γ-globulin, complement C4 and ESR all had statistically significant differences in the active group （P〈0.01）, so was the complement C3 （P〈0.05）. The accuracy of each indicator for the diagnosis of disease activity was DD〉 FDP〉 Complement C3, C4〉 γ-globulin〉 blood rheology index 〉 whole blood viscosity 〉 ESR. Conclusion： The fibrinolysis level and microcirculation were closely related to the disease activity of multi-organ damaged patients with connective tissue disease.