D-二聚体与缺血修饰白蛋白联合检测在心力衰竭中的应用价值

Application value of D-dimer and ischemia modified albumin for combined detection of heart failure

目的探讨联合检测D-二聚体与缺血修饰白蛋白(IMA)诊断心力衰竭的临床价值。方法 42例心力衰竭患者作为心力衰竭组(心功能Ⅱ级19例、Ⅲ级16例、Ⅳ级7例),42例进行体检的健康人作为健康组,检测两组D-二聚体、IMA及B型脑钠肽(BNP)水平,并进行比较;同时常规治疗心力衰竭患者,并检测不同心功能患者治疗后D-二聚体、IMA、BNP水平。结果心力衰竭组D-二聚体、BNP、IMA水平分别为(1.31±0.24)μg/ml、(941.8±144.2)pg/ml、(91.5±12.5)U/ml,均高于健康组的(0.20±0.06)μg/ml、(127.6±41.8)pg/ml、(67.2±10.7)U/ml,差异均具有统计学意义(P<0.05)。治疗后心功能Ⅳ级患者D-二聚体、BNP、IMA水平均高于心功能Ⅱ级与心功能Ⅲ级患者,差异均具有统计学意义(P<0.05);治疗后心功能Ⅲ级患者D-二聚体、BNP、IMA水平均高于心功能Ⅱ级患者,差异均具有统计学意义(P<0.05)。结论联合检测D-二聚体与IMA可有效诊断心力衰竭,并对治疗后效果予以评估,心功能越差者治疗效果越差,值得推广。

Objective To discuss the clinical value of D-dimer and ischemia modified albumin（IMA） for combined detection of heart failure. Methods There were 42 heart failure patients as heart failure group（19 cardiac function grade Ⅱ cases, 16 grade Ⅲ cases and 7 grade Ⅳ cases）, and 42 healthy people as healthy group. The D-dimer, IMA and B-type natriuretic peptide（BNP） level in two groups was detected and compared. The patients with heart failure were received routine treatment, and the levels of D-dimer, IMA, BNP after the treatment of patients with different grades of heart function were detected. Results Heart failure group had D-dimer, BNP and IMA level respectively as（1.31±0.24） μg/ml,（941.8±144.2） pg/ml and（91.5±12.5） U/ml, which were all higher than（0.20±0.06） μg/ml,（127.6±41.8） pg/ml and（67.2±10.7） U/ml in healthy group, and their difference was statistically significant（P〈0.05）. After treatment, cardiac function grade Ⅳ patients had higher D-dimer, BNP and IMA level than grade Ⅱ and Ⅲ patients, and their difference was statistically significant（P〈0.05）. After treatment, cardiac function grade Ⅲ patients had higher D-dimer, BNP and IMA level than grade Ⅱ patients, and the difference was statistically significant（P〈0.05）. Conclusion Combined detection of D-dimer and IMA can effectively diagnose heart failure. The effect of treatment after treatment is evaluated. The worse the heart function is, the worse the treatment effect. It is worth popularizing.