PCT、CRP、D-dimer联合检测在114例老年社区获得性肺炎的临床应用观察

社区获得性肺炎（CAP）在临床上较常见,有研究报道CAP致死率在我国近1%-12%[1],严重威胁人们的身体健康。老年社区获得性肺炎患者因基础疾病的积累,免疫力水平低下,感染后临床表现不典型,外周血常规也可正常,故寻找早期可靠指标及时地做出准确、有效的诊断及治疗策略,在临床工作中尤为重要。PCT作为一种新的敏感性、特异性均高且便于检测的炎性指标已广泛应用于临床,

CRP、D-Dimer对急性胰腺炎病程及预后分析价值探究

目的探究C反应蛋白(CRP)及D-二聚体(D-Dimer)在评估急性胰腺炎(AP)严重程度及预后因素的临床意义。方法选择89例急性胰腺炎患者,按照病情严重程度区分为轻度AP组(50例)和重度AP组(39例),分别于起病第1天、第5天和第7天检测2组患者血清CRP及D-Dimer水平,并分别按照是否出现器官衰竭、是否出现胰腺坏死将患者区分为2组,分别比较2组间血清CRP及D-Dimer水平。结果轻度AP组患者第1天、第5天和第7天血清CRP及D-Dimer水平均低于重度AP组(P<0.05);出现器官衰竭的AP患者与未发生器官衰竭的AP患者第1天时CRP及D-Dimer水平对比,差异不具有统计学意义(P>0.05),第5天及第7天出现器官衰竭AP患者上述因子水平明显高于未出现器官衰竭患者(P<0.05);出现胰腺坏死的AP患者第1天、第5天及第7天时CRP及D-Dimer水平均高于未出现胰腺坏死的AP患者(P<0.05)。结论CRP及D-Dimer对AP具有较重要的临床诊断意义,能够区分AP病程严重程度,并对其是否会出现器官衰竭、胰腺坏死等事件具有一定预测价值。

冠心病患者颈动脉超声检测与血浆hsCRP、D-dimer关系的探讨

目的研究冠心病患者冠心病颈动脉斑块及血hs-CRP、D-dimer水平的相关性。方法收集临床诊断冠心病患者80例,非冠心病对照组30例。冠心病组又分为急性心肌梗死、不稳定性心绞痛、稳定性心绞痛三个亚组。超声探测各组颈动脉IMT、Crouse积分;并检测血浆hsCRP、D-dimer水平;所得数据进行统计分析。结果①冠心病组IMT、Crouse积分、hsCRP、D-dimer浓度均高于对照组,差异有统计学意义(P<0.01)。②冠心病组三个亚组中IMT,Crouse积分差别无统计学意义(P>0.05)。SAP组、UAP组、AMⅠ组的hsCRP水平依次升高,差别具有统计学意义(P<0.05);与SAP组比,UAP组、AMⅠ组患者血D-dimer浓度显著升高,有显著差异(P<0.05);与UAP组比较,AMⅠ组hsCRP明显高于UAP组(P<0.05),D-dimer无显著性差异(P>0.05)。③经直线相关分析,D-dimer、hsCRP浓度分别与IMT及Grouse积分呈正相关;血浆D-dimer同时与hs-CRP有较好的相关性,相关系数为r=0.682,(P<0.05)。结论颈动脉超声检查,有助于识别冠心病高危患者。hsCRP、D-dimer是反映斑块的稳定性的可靠指标。颈动脉超声结合hsCRP、D-dimer检测,对冠心病患者不同缺血状态有一定的诊断价值。

动脉粥样硬化患者检测Lp(a)、hs-CRP、D-Dimer的临床意义

动脉粥样硬化（AS）发生多与肥胖、糖尿病、高血压、高血脂、高尿酸血症等因素有关,发病机制目前尚未明确,是临床冠心病、脑血管疾病、血栓栓塞等相关疾病的主要病理基础,可造成动脉管腔闭塞或破裂等严重并发症,严重危害人类生命健康。

中药益心饮方对急性心肌梗死患者血浆hs-CRP、Fib及D-dimer的影响

目的探讨分析中药益心饮方对急性心肌梗死患者血浆超敏C-反应蛋白(hs-CRP)、纤维蛋白原(Fib)及D-二聚体(D-dimer)的影响。方法选取2013年3月-2015年10月住院的急性心肌梗死患者110例,经随机对照试验法将其分为对照组和观察组各55例,2组患者均进行常规治疗,观察组加用中药益心饮方,比较分析2组患者治疗后血浆hs-CRP、Fib及D-dimer情况。结果观察组治疗后血浆hs-CRP、Fib及D-dimer改善优于对照组,差异有统计学意义(P<0.05)。结论在急性心肌梗死治疗中应用中药益心饮方,可有效减轻患者炎症反应,有利于机体凝血系统和纤溶系统之间平衡性的调节。

D-Dimer、h-CRP联合检测在脑梗死患者中的应用研究

目的探讨脑梗死患者血清D2聚体(D-Dimer)、超敏C反应蛋白(hs-CRP)联合检测的临床意义。方法选取2013年1月—2015年12月平凉市第二人民医院收治的126例急性脑梗死患者为观察组,选取同期126例正常健康体检者为对照组,使用STA Compact型全自动血凝仪检测两组对象的D2聚体(D-Dimer)水平;选用贝克曼AU6800全自动生化分析仪,采用免疫比浊法检测超敏C反应蛋白(h-CRP)水平,分析D-Dimer、h-CRP与脑梗死疾病发展程度的关系。结果观察组患者血清中D-Dimer、h-CRP含量明显高于对照组,差异有统计学意义(P<0.05)。急性脑梗死患者血清中D-Dimer、h-CRP含量随着脑梗塞病情好转(或加重)而降低(或升高),二者呈正相关。结论血清D-Dimer、h-CRP联合检测对脑梗塞患者临床诊断和制定治疗方案具有重要价值,可以依据患者治疗前后血清D-Dimer、h-CRP含量变化评估治疗效果和脑梗塞病情好转程度。

急性脑梗塞患者中医证候积分与血清D-Dimer、hs-CRP、Hcy、脑电图异常关系研究

目的:分析探讨急性脑梗塞患者中医证候积分与血D-Dimer、hs-CRP、Hcy水平及脑电图检查结果的关系。方法:收集急性脑梗塞患者161例为试验组,依据中医证候积分情况分为轻型组48例、中型组91例、重型组22例;另选60例健康人作为对照组。比较各组血D-Dimer、 hs-CRP、Hcy水平及脑电图检查结果的不同。结果:对照组血D-Dimer、hs-CRP、Hcy水平均正常,试验组治疗前血D-Dimer、hs-CRP、Hcy水平均明显升高。治疗28天后,试验组血D-Dimer、hs-CRP、Hcy水平均较治疗前明显下降,但高于对照组(P<0.05)。轻型、中型、重型三组血D-Dimer、hs-CRP、Hcy水平依次升高(P<0.05),脑电图异常阳性率依次升高(P<0.05)。结论:随着急性脑梗塞患者中医证候积分增加,血D-Dimer、hs-CRP、Hcy水平相对升高,脑电图异常阳性率相对升高,脑电图异常程度相应更重。

Impact of D-dimer on in-hospital mortality following aortic dissection:A systematic review and meta-analysis

BACKGROUND The utility of D-dimer(DD)as a biomarker for acute aortic dissection(AD)is recognized.Yet,its predictive value for in-hospital mortality remains uncertain and subject to conflicting evidence.AIM To conduct a meta-analysis of AD-related in-hospital mortality(ADIM)with elevated DD levels.METHODS We searched PubMed,Scopus,Embase,and Google Scholar for AD and ADIM literature through May 2022.Heterogeneity was assessed using I2 statistics and effect size(hazard or odds ratio)analysis with random-effects models.Sample size,study type,and patients’mean age were used for subgroup analysis.The significance threshold was P<0.05.RESULTS Thirteen studies(3628 patients)were included in our study.The pooled prevalence of ADIM was 20%(95%CI:15%-25%).Despite comparable demographic characteristics and comorbidities,elevated DD values were associated with higher ADIM risk(unadjusted effect size:1.94,95%CI:1.34-2.8;adjusted effect size:1.12,95%CI:1.05-1.19,P<0.01).Studies involving patients with a mean age of<60 years exhibited an increased mortality risk(effect size:1.43,95%CI:1.23-1.67,P<0.01),whereas no significant difference was observed in studies with a mean age>60 years.Prospective and larger sample size studies(n>250)demonstrated a heightened likelihood of ADIM associated with elevated DD levels(effect size:2.57,95%CI:1.30-5.08,P<0.01 vs effect size:1.05,95%CI:1.00-1.11,P=0.05,respectively).CONCLUSION Our meta-analysis shows elevated DD increases in-hospital mortality risk in AD patients,highlighting the need for larger,prospective studies to improve risk prediction models.

Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

D-Dimer: Predictor of Postpartum Hemorrhage among Pre-Eclampsia at Kilimanjaro Christian Medical Centre

Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, the cut-off point of a D-dimer level of 0.66 µg/ml significantly predicts postpartum hemorrhage with a sensitivity of 75% and specificity of 55%. For those who had no severe features the cut-off point was 0.53 µg/ml with a sensitivity of 95% and specificity of 53%, and for those who had severe features the cut-off point was 3.58 µg/ml with a sensitivity of 50% and specificity of 96%. Conclusion: D-dimer can be used to predict postpartum hemorrhage among pre-eclampsia, especially among those who have severe features. This shows that D-dimer has specificity in predicting PPH in women with pre-eclampsia and can be applied in clinical services to save women from maternal morbidity and mortality. Blood products such as fresh frozen plasma, platelets, and whole blood together with tranexamic acid should be readily available in women with pre-eclampsia especially those with severe features with a D-dimer level of 3.58 µg/ml and above during delivery as they are at high risk of developing PPH.

Analysis of the Role of D-Dimer,Interleukin-6,and Interleukin-18 in Differential Diagnosis of Pediatric Refractory Mycoplasma pneumoniae Pneumonia

Objective:To analyze the value of D-dimer(D-D),interleukin-6(IL-6),and IL-18 in the differential diagnosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods:The medical records of 92 children with Mycoplasma pneumoniae pneumonia(MPP)treated in the hospital were selected for retrospective analysis from January 2023 to January 2024.After comprehensive examinations such as computed tomography examination of the chest,48 children with general Mycoplasma pneumoniae pneumonia(GMPP)were put in the GMPP group and 44 children with RMPP were grouped in the RMPP group.The IL-6,IL-18,and D-D levels were compared between the two groups,and the receiver operating characteristic(ROC)curves were plotted to analyze their value for differential diagnosis of RMPP.Results:The levels of IL-6,IL-18,and D-D in the RMPP group were higher than those in the GMPP group(P<0.05);the ROC curves showed that the specificity of the differential diagnosis of IL-6,IL-18,and D-D was higher,and their diagnostic value was significant.Conclusion:Determination of IL-6,IL-18,and D-D levels in children with MPP can further diagnose the children’s condition,which can help physicians formulate targeted treatment plans,and is of great significance to the improvement of the children’s condition,which is worthy of attention.

Correlation Analysis Between Changes of D-Dimer Level and Rheumatoid Arthritis Complicated with Interstitial Lung Disease

Objective:To explore the correlation between the change of D-dimer level and rheumatoid arthritis complicated with interstitial lung disease.Methods:From January 2022 to February 2024,20 rheumatoid arthritis patients complicated with interstitial lung disease(interstitial lung disease group),20 rheumatoid arthritis patients without interstitial lung disease(without interstitial lung disease group),and 20 healthy people(control group)in Xijing Hospital were selected for this study.The fasting venous blood of the three groups of subjects was collected and their D-dimer,C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were detected.Subsequently,the correlation between each index and rheumatoid arthritis complicated with interstitial lung disease was analyzed.Results:The D-dimer level of the interstitial lung disease group was significantly higher than the other two groups(P<0.05).The D-dimer level of the group without interstitial lung disease was significantly higher than the control group(P<0.05).CRP levels in the interstitial lung disease group and the group without interstitial lung disease were significantly higher than those of the control group(P<0.05).The ESR and RF levels of the interstitial lung disease group were significantly higher than the other two groups(P<0.05).The levels of ESR and RF levels of the group without interstitial lung disease were significantly higher than the control group(P<0.05).Conclusion:D-dimer levels of rheumatoid arthritis patients are higher than those of healthy individuals,and those complicated with interstitial lung disease present even higher levels.This finding shows that there is a correlation between D-dimer levels and rheumatoid arthritis with interstitial lung disease,which may facilitate the evaluation and diagnosis of this disease.

血栓前状态标志物F1+2、TAT、AT-Ⅲ、D-Dimer对早期复发性流产的预测价值

【目的】探讨血栓前状态分子标志物:凝血酶原片段F1+2(F1+2)、凝血酶-抗凝血酶Ⅲ复合物(TAT)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(D-Dimer)与早期复发性流产(RSA)的关系,及各分子标志物对血栓前状态(PTS)引起的RSA的诊断价值。【方法】比较103例RSA已孕者(AEP组)、103例有RSA病史现未孕者(ANP组)及40例正常早孕者(NEP组)及40例健康未孕者(NNP组)血清中F1+2、TAT、AT-Ⅲ、D-Dimer水平;并以ROC曲线方法判断PTS引起的RSA发生时以上各个指标的最佳临界值。【结果】1.ANP组血浆F1+2、D-Dimer水平显著高于NNP组,两者间差异有显著性(P<0.008);而且流产3次者较2次者指标水平高,差别有统计学意义(P<0.0167)。F1+2与D-Dimer判断RSA未孕患者存在血栓前状态的最佳筛查界值分别为55.11nmol/L(AUC=0.767)及233.50μg/L(AUC=0.636)。2.ANP组血浆TAT水平高于NNP组,AT-Ⅲ水平低于NNP组,但其差别无统计学意义(P>0.008)。AEP组血浆F1+2、TAT、D-Dimer水平高于NEP组,AT-Ⅲ水平低于NEP组,但其差别无统计学意义(P>0.008)。【结论】RSA与PTS存在相关性;RSA患者在孕前已经表现为PTS,PTS的标志物F1+2、D-Dimer可用于RSA未孕人群流产原因的筛查,其水平越高,流产可能性越大。

Application of Echocardiography Combined with Blood SAA, IL-6, PCT, and CRP Detection in the Diagnosis and Treatment of Kawasaki Disease in Children

Objective: To understand the application of echocardiography combined with blood SAA, IL-6, PCT, and CRP detection in the diagnosis and treatment of Kawasaki disease in children. Methods: 56 children with Kawasaki disease were selected as the study subjects as the treatment group, and 54 children with other diseases during the same period were selected as the control group. Echocardiography, blood SAA, IL-6, PCT and CRP were detected before and after treatment to observe the results of the two groups. A database was established to compare the changes of various indicators between the two groups, as well as the application value of each indicator in the clinical diagnosis and treatment of Kawasaki disease, and the pros and cons of the application of each indicator in the diagnosis and treatment of children with Kawasaki disease were analyzed, so as to provide a clearer early warning mechanism for the clinical diagnosis and treatment of children with Kawasaki disease. Results: There was no significant difference in the results of related imaging indexes in the control group before and after treatment (P > 0.05). There was no significant difference in the results of relevant imaging indicators in the treatment group before and after treatment (P > 0.05), except for LMCA (P < 0.05). The comparison of imaging related indicators before and after treatment between the two groups showed that except for no statistically significant difference in LMCA and RMCA before treatment (P > 0.05), all other indicators had statistical significance (P < 0.05). The results of relevant laboratory indexes in control group before and after treatment were statistically significant (P < 0.05). The results of relevant laboratory indexes before and after treatment in the treatment group were statistically significant (P < 0.05). The results of relevant laboratory indicators were compared between the two groups, except for the results of SAA, IL-6 and PCT before treatment, which were not statistically significant (P > 0.05), the differences in all other indicators were statistically significant (P Conclusion: The combination of echocardiography with blood SAA, IL-6, PCT, and CRP detection can establish the optimal evaluation plan for accurate and effective diagnosis, treatment, and prognosis of Kawasaki disease in children, providing more accurate and reliable diagnostic and treatment methods and laboratory data for clinical practice, and thus providing strong protection for children’s health.

糖尿病并冠心病患者HbA1c和D-dimer检测情况分析

目的:探讨糖尿病并冠心病患者糖化血红蛋白(HbA1c)和D-二聚体(D-dimer)检测情况。方法:采用回顾性分析的方法,分析我院收治的糖尿病患者临床资料,分为对照组和单纯糖尿病组、糖尿病并冠心病组。结果:糖尿病并冠心病患者FBG、HbA1c、(C反应蛋白)CRP、D-dimer均明显高于对照组和单纯糖尿病组,P<0.01,差异均有统计学意义,而对照组和单纯糖尿病组D-dimer无明显差异,P>0.05.结论:早期对HbA1c、CRP、D-dimer检测可以为糖尿病并冠心病患者血糖控制和冠心病诊治提供可靠的理论依据。

D-dimer、C反应蛋白和脑钠肽在肺栓塞患者的临床诊断价值及灵敏度、特异度和准确度对比研究

目的探讨D-Dimer、C-反应蛋白和脑钠肽在肺栓塞患者的临床诊断价值以及灵敏度、特异度和准确度对比研究。方法随机选取2013年5月~2014年5月间收治的大面积肺栓塞患者45例,小面积肺栓塞患者45例,并选取同期体检的健康者45例作为对照组。检测并比较治疗前后各组血浆D-Dimer、CRP和BNP水平。采用Logistic分析患者血浆D-Dimer、CRP和BNP水平与肺栓塞发生的相关性。以肺栓塞检验金标准(肺动脉造影)分别与D-dimer检验、CRP检验和BNP检验法做配对卡方检验,计算Ddimer检验、CRP检验和BNP检验3种检测方法的灵敏度、特异度和准确度,并比较其差异。结果治疗前,大面积组和小面积组肺栓塞D-Dimer、CRP和BNP水平均显著高于对照组(P<0.05);大面积组D-Dimer、CRP和BNP水平也明显高于小面积组(P<0.05)。治疗后,大面积组和小面积患者血浆D-Dimer、CRP和BNP水平明显下降(P<0.05),且与正常对照组比较,差异无统计学意义。Logistic分析结果表明,血浆D-Dimer、CRP和BNP水平与肺栓塞的发生呈正相关性(r=3.11,P<0.05;r=4.36,P<0.05;r=2.86,P<0.05)。D-Dimer检测、CRP检测和BNP检测方法在检测灵敏度、特异度和准确度方面差异无统计学意义。结论 D-dimer、C-反应蛋白和脑钠肽水平与肺栓塞的发生呈正相关性,是评估患者病情的重要指标,具有十分重要临床指导价值。

D-dimer与纤维蛋白原比值在静脉血栓栓塞诊断中的应用价值

目的探讨D-dimer、纤维蛋白原(Fg)、D-dimer与Fg比值(D/F)以及C反应蛋白(CRP)在静脉血栓栓塞(VTE)中的临床诊断价值。方法对民航总医院就诊的221例急诊与住院疑似VTE患者D-dimer、Fg及CRP进行检测,并计算D/F,采用胸部CT、病理诊断等对疑似患者明确诊断。结果 VTE人群的Fg水平低于非VTE人群(t=6.421,P<0.01),而D-dimer、D/F、CRP均显著增高;在VTE诊断灵敏度达到100%时,D/F特异度与阳性预测值(PPV)(73.2%,56.4%)优于使用单独使用D-dimer(47.0%,39.6%);ROC曲线分析表明上述指标在VTE诊断中的准确性顺序为D/F>D-dimer>CRP。结论采用D/F可提高VTE临床诊断的特异性,可作为一项有益的指标应用于VTE辅助诊断。

东菱克栓酶对脑梗塞患者血浆 t-PA、D-dimer 的调节及临床意义

随机将４７例脑梗塞患者分成二组，分别采用东菱克栓酶（ＤＦ－５２１）及低分子右旋糖酐丹参（低右组）治疗，并同时观察疗效及检测治疗前后血浆组织型纤溶酶原激活剂（ｔ－ＰＡ）、Ｄ－二聚体（Ｄ－ｄｉｍｅｒ）值。结果表明，急性脑梗塞治疗前血浆中ｔ－ＰＡ明显低于对照组（Ｐ＜０．０５），Ｄ－ｄｉｍｅｒ明显高于对照组（Ｐ＜０．００１）；治疗后ｔ－ＰＡ较治疗前增加，以ＤＦ－５２１组为明显（Ｐ＜０．００５，低右组Ｐ＞０．０５）。用药后二组Ｄ－ｄｉｍｅｒ相比较有显著差异（Ｐ＜０．０１）；ｔ－ＰＡ相比也有差异（Ｐ＜０．０５）。ＤＦ－５２１组治疗脑梗塞有效率明显优于低右组（Ｐ＜０．０５）。提示：早期使用ＤＦ－５２１能增加纤溶酶活性，促进血栓溶解，加速神经功能恢复。

血浆D-dimer在预测及评估恶性黑色素瘤转移中临床应用分析

目的通过构建恶性黑色素瘤动物血行转移模型,发现出现血行转移时血浆D-dimer明显升高,通过检测恶性黑色素瘤患者血液标本D-dimer、FIB等相关指标以及结合病理影像学结果比较其诊断效率,评估D-dimer诊断恶性黑色素瘤血行转移的临床价值。方法首先选取常见的高侵袭性恶性黑色素瘤细胞系B16/F10构建小鼠肺转移模型,尾静脉注射2周后,观察肺转移情况并检测血浆D-dimer的水平变化。回顾性分析了2009年1月至2019年1月就诊于西安交通大学第一附属医院的78例恶性黑色素瘤患者的血液标本和病理资料。结果B16/F10实验组小鼠血浆D-dimer[(1.04±0.15)mg/L]明显高于PBS对照组[(0.56±0.11)mg/L,(P<0.001)],解剖小鼠后可以很明显在实验组观察到肺转移灶。进一步回顾性分析78例恶性黑色素瘤患者,其中25例转移患者的血浆D-dimer的中位水平为1.0 mg/L,高于未转移患者的0.5 mg/L(P<0.001);此外,采用D-dimer诊断远处转移的ROC曲线下面积为0.831、95%可信区间为0.726~0.936,具有统计学意义(P<0.001)。结论D-dimer作为一种无创、廉价、快速的检测方法,可以作为预测恶性黑色素瘤血样转移的重要指标。本研究为其在恶性黑色素瘤血行转移及常规筛查方面的应用提供了依据。