D-二聚体对血液病合并弥散性血管内凝血的诊断价值

Diagnostic value of D- dimer in blood disorders combined with disseminated intravascular coagulation

目的探讨D-二聚体(D-Dimer)在血液病合并弥散性血管内凝血(Disseminated intravascular coagulation,DIC)患者诊断中的应用价值。方法选择深圳市龙华新区中心医院2013年1月—2015年2月收治的血液病合并DIC患者71例为观察组,另选血液病未合并DIC患者70例为对照组,分别对两组对象进行血浆D-D水平测量,评估D-D在血液病合并DIC中的诊断意义。结果观察组D-D水平明显较对照组高(P<0.05),血液病合并DIC患者早期D-D水平明显低于中期与晚期,中期低于晚期,差异均有统计学意义(P<0.05);对不同分期患者采取凝血活化指标包括纤维蛋白原(FG)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原降解产物(FDP)、鱼精蛋白副凝集实验(3P)等检测方法进行诊断,结果显示,D-D与FDP阳性率明显高于其他检测方法,差异有统计学意义(P<0.05)。结论血液病合并DIC患者采取D-D诊断具有可行性,早期检出率高,且操作简单,重复性强,值得临床推广应用。

Objective To determine the application value of D- dimer（D- D）in the diagnosis of blood disorderscombined with disseminated intravascular coagulation（DIC）. Methods A total of 71 patients with blood disorders combinedwith DIC hospitalized in Central Hospital of Longhua New District from January 2013 to February 2015 were enrolled in thisstudy,and assigned into observation group. And another 70 patients suffering from blood disorders but without DIC admitted inthe hospital at the same period were selected as the control group. Their plasma D- D levels were measured,and thesignificance of D- D was evaluated in the diagnosis of blood disorders combined with DIC. Results The D- D level wassignificantly higher in the observation group than the control group（P〈0.05）. The level was also obviously lower in the patientsfrom observation group at the early stage than those at the middle and late stage（P〈0.05）,and those at the middle stage thanthose at the late stage（P〈0.05）. In the detections of fibrinogen（FG）,prothrombin time（PT）,thrombin time（TT）,fibrinogendegradation products（FDP）,and protamine agglutination test（3P）for the patients at different stages,the results showed thatthe positive rates of D-D and FDP were significantly higher than those of other detection indicators（P〈0.05）. Conclusion Detection of plasma D-D level is feasible and with high early detection rate in the diagnosis of blood disorder combined withDIC. It is easy to operation,of high repeatability,and worthy of clinical application.