动态观察D-二聚体对重症社区获得性肺炎预后的评价

Dynamic observations plasma D-dimer indicate the prognosis of patients with severe community acquired pneumonia

目的探讨血浆D-二聚体（D-D）对重症社区获得性肺炎（scAP）严重程度及预后的评估价值，为SCAP治疗及预后的判定提供参考指标。方法将SCAP患者按预后分为生存组和死亡组，分别于入组第1天，第5天及观察终点（出院／转普通病房或死亡前最后一次）采集外周血检测D-D。结果生存组和死亡组患者第5天及观察终点的两者差异均有统计学意义（P〈O．01），且死亡组患者的D-D水平明显高于存活组（P〈O．01）。同一组患者不同时点的D-D差异有统计学意义（P〈0．01），死亡组D-D进行性升高；生存组D-D进行性下降。结论持续升高的DD往往提示病情危重，预后不良。

Objective To investigate the order of severity and prognostic value of plasma D-dimer （D-D） levels in patients with severe community acquired pneumonia （SCAP） and to provide the basis for treatment and prognosis of SCAP. Methods As the prognosis, patients were divided into a survival group or a death group. All patients were extracted peripheral blood serum 5 ml in early morning hollow of Day 1, Day 5 and the clinical endpoint （the final measurement before hospital discharge or death）, and measured in the clinical laboratory immediately. Results D-D measurements on Day 5 and at the clinical endpoint showed significantly different （ P〈0.01）, I〉D levels of the death group were significantly higher than the survival group （ P〈0.01）, D-D measurements within the same group were significantly different at different time points （P〈0.01）. In the survival group, D-D levels decreased. In the death group, D-D levels increased. Conelusions Increasing plasma D-D levels are indicators of a poor outcome for patients with SCAP.