血浆D-二聚体与肝硬化腹水相关性研究

High D-dimer Plasma Levels are associated with Ascites in liver cirrhosis Patients

目的:探讨肝硬化患者血浆D-二聚体与腹水的关系及其临床意义。方法:回顾性分析我院2012年1月至2015年8月收治的65例肝硬化患者,根据腹水的有无分为有腹水组和无腹水组,比较两组患者的D-二聚体值,同时比较腹水组腹水消退前后的血浆D-二聚体值。分析血浆D-二聚体值与腹水红细胞数的相关性。随访1年,并检测再发腹水者的血浆D-二聚体值。结果:腹水组患者D-二聚体值为(13.47±4.87)ug/ml,无腹水组为(4.81±1.01)ug/ml,两组比较差异有显著性意义,(p=0.000)。腹水消退前后的D-二聚体值分剐为(13.47±4.87)ug/ml和(5.87±1.42)ug/ml,差异有显著性意义,(p=0.000)。血浆D-二聚体值和腹水红细胞数有正相关性(R2=0.860,p=0.000)。腹水复发者血浆D-二聚体值为(20.16±2.10)ug/ml,高于未复发者的平均水平。结论:肝硬化腹水患者伴随有血浆D-二聚体值的升高,且腹水中红细胞计数与血浆D-二聚体水平显正相关性。

Objective：To investigate the relationship between plasma D-dimer and cirrhotic ascites. Methods：The clinical data of 65 cases for diagnosis of cirrhosis from January 2012 to August 2015 were analyzed retrospectively. 65 cirrhosis patients were divided into ascites group and non-ascites group, the D-dimer values between the two groups were compared. At the same time, the plasma levels of D-dimer in the as- cites group were compared before and after the ascites dissolved. The association between the plasma levels of D-dimer and the number of red blood cells in ascites was analyzed. During the follow-up of 1 years, the plasma levels of D-dimer were tested in the patients with recurrence of ascites. Results： On D-dimer value, the 32 cases group with aseites were （ 13.47 ± 4, 87 ） ug/ml, and the 33 cases group without ascites were （4.81±1. 01 ） ug/ml; Before and after the ascites subsided, they were （ 13.47 ±4.87） ug/ml and （5.87±1.42） ug/ml respective- ly. There were significant difference between the two groups （ P = 0. 000）. There was a positive correlation between the plasma D-dimer and the number of red blood cells in ascites （ R2 = 0. 860, P = 0. 000）. The plasma level of D-dimer in the patients with ascites recurrence were （20.16 ± 2.10）ug/ml,which had an increased tendency compared to the non recurrence. Conclusion：The incidence of ascites in patients with cirrhosis are often accompanied by elevated D-dimer. And this part of the patients should be required more careful observation, because they may be more likely to occur again in ascites and disease progression.