D-二聚体对缺血性肠病及其严重程度的临床早期诊断价值

Clinical value of D-dimer for early diagnosis and severity of ischemic bowel disease

目的探讨D-二聚体对缺血性肠病及其严重程度的临床早期诊断价值。方法回顾近13年来该院消化科收治的缺血性肠病患者59例为观察组,及同期收治的内镜下证实的反流性食管炎、消化性溃疡(合并出血者除外)、胃肠道息肉患者共59例为对照组,比较两组入院后24h内D-二聚体水平之间的差异,并进一步比较观察组中有溃疡与无溃疡者、单发溃疡与多发溃疡者之间D-二聚体的差异。结果入院后24h内D-二聚体水平,观察组高于对照组,差异有统计学意义(P<0.05),但仍在正常范围内。观察组中,有溃疡组与无溃疡组之间差异无统计学意义(P>0.05),单发溃疡组与多发溃疡组之间差异无统计学意义(P>0.05)。结论该研究不支持D-二聚体可用于缺血性肠病的临床早期诊断,且其与病情的严重程度无明显相关。

Objective To explore clinical value of D-dimer for early diagnosis and severity of ischemic bowel disease.MethodsTotally 59 patients with ischemic bowel disease diagnosed by gastroenterology department of this hospital in recent 13 years were included retrospectively as observation group.Another 59 patients with reflux esophagitis,peptic ulcer（except for bleeding merged）and gastrointestinal polyps confirmed by endoscopy during the same period were included as control group.D-dimer within 24 hours after admission of the two groups was compared.In the observation group,D-dimer of the ulcer group and no ulcer group,single ulcer group and multiple ulcer group was compared further more.Results The D-dimer level within 24 hours after admission of the observation group was higher than that of the control group（P〈0.05）,but it was still within the normal range.In the observation group,there was no statistically significant difference of D-dimer between the ulcer group and no ulcer group（P〈0.05）,D-dimer between the single ulcer group and multiple ulcer group had no statistically significant difference,either（P〈0.05）.ConclusionThis study does not support the concept that D-dimer can be used for the clinical early diagnosis of ischemic bowel disease,and there is no significant correlation between D-dimer and the severity of ischemic bowel disease.