D-二聚体检测在急性主动脉夹层诊断中的应用价值

Application Value of D-dimer Detection in the Diagnosis of Acute Aortic Dissection

目的:分析D-二聚体(D-D)检测在急性主动脉夹层(AAD)诊断中的应用价值。方法:选取2022年1月—2023年1月秭归县人民医院收治的64例AAD患者作为观察组,其中典型34例,非典型30例;Stanford A型29例,Stanford B型35例。选取同期健康体检者50例作为对照组。两组均行D-D检测,比较两组D-D水平以及典型AAD患者与非典型AAD患者发病不同时间段(发病12、24、72 h及14 d)D-D水平,Stanford A型、Stanford B型患者发病不同时间段D-D水平。以造影诊断为“金标准”,分析D-D检测诊断AAD的准备率。结果:观察组D-D水平高于对照组,差异有统计学意义(P=0.001)。典型AAD患者发病24 h D-D水平高于非典型AAD患者,差异有统计学意义(P=0.011)。不同发病时间段,Stanford A型患者D-D水平均高于Stanford B型患者,差异有统计学意义(P<0.05)。D-D检测诊断典型AAD、非典型AAD、Stanford A型AAD、Stanford B型AAD的准确率与血管造影比较,差异无统计学意义(P>0.05)。结论:D-D可用于鉴别AAD患者与健康者,且对典型与非典型AAD患者患病初期有辨识价值,在疾病分型诊断中能区别Stanford分型,可辅助临床诊断AAD病型,值得应用。

Objective:To analyze the value of D-dimer(D-D)detection in the diagnosis of acute aortic dissection(AAD).Methods:A total of 64 patients with AAD treated in Zigui County People´s Hospital were selected as the observation group from January 2022 to January 2023,of which 34 were typical and 30 were atypical.There were 29 cases of Stanford type A and 35 cases of Stanford type B.Fifty healthy subjects were selected as control group.D-D detection was performed in both groups,and D-D levels in the two groups were compared as well as D-D levels in different time periods(12,24,72 h and 14 d)between typical AAD patients and atypical AAD patients,and D-D levels in different time periods between Stanford type A and Stanford type B patients.Taking contrast diagnosis as the‘gold standard’,the preparation rate of D-D detection for diagnosis of AAD was analyzed.Results:The level of D-D in observation group was higher than that in control group,and the difference was statistically significant(P=0.001).The level of D-D at 24 h after onset of typical AAD was higher than that of atypical AAD,and the difference was statistically significant(P=0.011).The D-D level of Stanford type A patients was higher than that of Stanford type B patients at different time periods,and the difference was statistically significant(P<0.05).There was no significant difference in the accuracy of D-D detection in the diagnosis of typical AAD,atypical AAD,Stanford type A AAD,Stanford type B AAD compared with angiography(P>0.05).Conclusion:D-D can be used to distinguish AAD patients from healthy people,and it is valuable for distinguishing typical AAD patients from atypical AAD patients at the early stage of disease.D-D can distinguish Stanford classification in disease classification diagnosis,and can assist clinical diagnosis of AAD disease,which is worthy of application.