血浆D-二聚体与急性主动脉夹层患者住院死亡的相关性分析

Analysis of correlation between D-dimer level and in-hospital mortality in acute aortic dissection patients

目的探讨入院D-二聚体水平与急性主动脉夹层(AAD)患者住院死亡的相关性。方法 141例AAD患者按住院期间是否死亡分为死亡组和存活组,比较两组患者入院D-二聚体、临床特征及辅助检查结果,使用多因素logistic回归分析探讨入院D-二聚体水平与AAD患者住院死亡的相关性。结果死亡组患者入院D-二聚体水平、D-二聚体升高(≥20μg/ml)比例[(13.6±7.5)μg/ml、51.9%]高于存活组[(8.0±7.0)μg/ml、18.4%],差异有统计学意义(P<0.01)。多因素log is tic回归分析结果显示,矫正常见混杂因素及手术治疗等因素后,入院D-二聚体升高(≥20μg/ml)为AAD患者住院死亡的独立危险因素(模型1 OR=3.286,95%CI:1.194~9.045;模型2 OR=5.378,95%CI:1.131~25.563)。结论入院D-二聚体升(≥20μg/ml)的AAD患者住院死亡风险较高。

Objective To investigate the association of D-dimer level on admission with in-hospital mortality in AAD patients.Methods141AAD patients hospitalized from January2012to December2014were enrolled and divided into survival group and deceased group according to whether died during hospitalization.D-dimer levels on admission,clinical features and adjunctive examinations were compared between the two groups.Multivariate logistic regression analysis was performed to investigate the relation between D-dimer level on admission and in-hospital death.Results D-dimer level and the percentage of patients with elevated D-dimer level on admission(20ug/ml)were significantly higher in deceased group than in survival group(13.6±7.5ug/ml,51.9%vs.8.0±7.0ug/ml,18.4%,respectively,all P<0.001).Multivariate logistic regression analysis showed that elevated D-dimer level on admission(≥20ug/ml)was an independent risk factor for in-hospital death in patients with AAD(model1OR=3.286,95%CI:1.194-9.045;model2OR=5.378,95%CI:1.131-25.563).Conclusion The patients with AAD and elevated D-dimer level(≥20ug/ml)on admission have a higher risk of in-hospital death.