血浆D-D、Fib及FDP在肺栓塞治疗中的意义

Changes and Significance of Plasma D-Dimer,Fibrinogen and Fibrinogen Degradation Product in Patients with Pulmonary Embolism before and after Treatment

目的探讨血浆D-二聚体(D-D)、纤维蛋白原(Fib)及其降解产物(FDP)在肺栓塞患者治疗前后的变化及意义。方法选取笔者医院62例确诊为肺栓塞患者作为肺栓塞组,根据肺栓塞高危与否分为高危组10例,中危组35例,低危组17例。根据治疗效果分为有效组40例和无效组22例,同时选健康志愿者40例作为对照组,测定血清中D-D、Fib和FDP水平。结果肺栓塞组血清中D-D、FDP水平较对照组均增高,差异有统计学意义(t=3. 78、2. 93,P <0. 05)。治疗前,肺栓塞中危组和高危组患者血清中D-D、FDP水平较低危组增高,差异有统计学意义(F=8. 34、4. 93,P <0. 05)。经过治疗,3个亚组血清中D-D、FDP水平均较治疗前降低,差异有统计学意义(t=2. 42、4. 64、2. 97、3. 56、3. 82、2. 95,P <0. 05)。经过治疗,无效组和有效组血清中D-D、FDP水平均较治疗前降低,差异有统计学意义(t=2. 74、2. 53、3. 73、3. 06,P <0. 05)。结论肺栓塞患者血清中D-D、Fib和FDP水平与肺栓塞的严重程度有关,经治疗后血清中D-D和FDP水平会有一定程度的降低,将D-D、Fib和FDP三者联合对判断肺栓塞严重程度及治疗效果有一定临床意义。

Objective To investigate the changes and significance of plasma D-dimer(D-D),fibrinogen(Fib)and fibrinogen degradation product(FDP)in patients with pulmonary embolism(PE)before and after treatment.Methods sixty two PE patients treated in our hospital were selected as PE group and further divided into high-risk group(10 cases),intermediate-risk group(35 cases),low-risk group(17 cases),effective group(40 cases)and invalid group(22 cases).And 40 healthy individuals were selected as the control group.Serum D-D,Fib and FDP levels were measured.Results The levels of D-D and FDP in the pulmonary embolism group were higher than those in the control group,and the differences were statistically significant(t=3.78,2.93,P<0.05).Before treatment,the serum levels of D-D and FDP in the middle and high risk groups of the pulmonary embolism were higher than those in the low risk group,and the differences were statistically significant(F=8.34,4.93,P<0.05).After treatment,the levels of D-D and FDP in the serum of three subgroups were lower than those before the treatment,and the differences were statistically significant(t=2.42,4.64,2.97,3.56,3.82,2.95,P<0.05).After treatment,the levels of D-D and FDP in the serum of the ineffective group and the effective group were lower than those before the treatment,and the difference was statistically significant(t=2.74,2.53,3.73,3.06,P<0.05).Conclusion The D-D,Fib and FDP levels are correlated with the severity of the disease among PE patients.After treatment,the serum D-D and FDP levels will decrease in a certain extent,so the combined detection of those levels have certain clinical significance in judging the severity and efficacy.