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.

急性下肢深静脉血栓患者置管溶栓前后D-D、F1+2、P-selectin变化及意义

目的 探究急性下肢深静脉血栓形成(DVT)患者置管溶栓前后D-二聚体(D-D)、凝血酶原片段1+2(F1+2)、P选择素(P-selectin)变化及临床意义。方法 选取2020年3月至2022年3月云南省第三人民医院186例急性DVT患者作为研究对象,均行置管溶栓术,术后12个月以门诊形式进行随访,4例失访,共182例完成术后随访。根据术后12个月是否发生血栓后综合征(PTS)分为PTS组(n=27)、非PTS组(n=155),比较2组一般资料及溶栓前后血浆D-D、F1+2、P-selectin表达,Logistic分析PTS发生影响因素,受试者工作特征曲线(ROC)、曲线下面积(AUC)分析血浆D-D、F1+2、P-selectin预测PTS发生价值,采用相对危险度(RR)分析不同血浆D-D、F1+2、P-selectin表达对PTS的影响。结果 PTS组年龄、BMI、静脉通畅评分及溶栓后1周、1个月血浆D-D、F1+2、P-selectin表达高于非PTS组(P <0.05);Logistic显示:BMI及溶栓后1周、1个月血浆D-D、F1+2、P-selectin是急性DVT患者发生PTS的影响因素(P <0.05);ROC曲线,溶栓后1个月血浆D-D、F1+2、P-selectin联合预测PTS效能明显优于溶栓后1周D-D、F1+2、P-selectin联合预测效能;溶栓后1个月血浆D-D、F1+2、P-selectin高表达患者发生PTS风险是低表达的4.211、2.550、3.189倍。结论 急性DVT患者置管溶栓后血浆D-D、F1+2、P-selectin表达升高,其联合预测患者发生PTS具有一定预测效能。

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.

Effect of Tongmai Jiangzhi Oral Liquid (通脉降脂口服液) on Serum P-selectin, von Willebrand Factors and D-Dimer in Patients with Atherosclerosis

Objective: To explore the role of cytokines on the pathogenesis of atherosclerosis, and the effect of Tongmai Jiangzhi oral liquid (通脉降脂口服液,TMJZ) on cytokines through observing serum P-se-lectins (Ps), von Willebrand (vWF), and D-dimer (D-D) in atherosclerosis (AS) patients. Methods: Sixty-three AS patients were randomly divided into the treated group (n = 33, treated with TMJZ, 10 ml each time, three times a day) and the control group (n = 30, treated with Lovastatin, 10 mg, once daily). The levels of serum lipids (enzymatic methods), Ps, vWF, and D-D were measured before and after 8 weeks of treatment. Results: Serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), apo-protein B-100 (apoB-100) were significantly decreased (P<0.05 or P< 0.01) and high-density lipoprotein cholesterol (HDL-C) was significantly raised (P<0.05) after TMJZ treatment. Serum Ps, vWF, and D-D also declined (P<0.05) after treatment. There was no significant difference between the treated and the control groups in these parameters except serum HDL-C level. Conclusion: TMJZ has good therapeutic effect in regulating serum lipids, improving endothelial cell function, inhibiting activation of platelets, and preventing the disturbance of blood coagulation/fibrinolysis function in patients with AS.

凝血功能四项、FDP及D-Dimer检测在产后出血诊断中的应用分析

目的分析产后出血诊断中凝血功能四项、D-Dimer、FDP检测的应用。方法将100例于本院分娩产妇依据产后出血发生情况分为发生组和未发生组两组各50例,对所有产妇的TT、PT、APTT、FIB等凝血功能四项水平进行测定并分析,对D-dime、FDP水平进行测定并分析。结果分娩后,发生组的PT、APTT均长于未发生组(P<0.05),FIB水平低于未发生组(P<0.05)。分娩前后发生组的D-Dimer、FDP水平均高于未发生组(P<0.05)。分娩前后发生组的凝血功能四项、D-Dimer、FDP检测正常率均低于未发生组(P<0.05),异常率均高于未发生组(P<0.05)。结论产后出血诊断中凝血功能四项、D-Dimer、FDP检测的应用价值高。

PCT、IL-6与D-Dimer、TAT联合检测评估患者细菌感染程度和发生血栓风险的研究

探讨PCT、IL-6与D-Dimer、TAT联合检测在评估患者细菌感染程度和发生血栓风险的临床应用价值。方法 收集和选用无血栓背景的肺部细菌感染患者样本55例、脓毒血症患者样本66例、无细菌感染的样本10例,总样本量共131例。采用化学发光法(CLIA)检测患者血浆中PCT、IL-6与D-Dimer、TAT的表达水平,比较4中血浆标志物的表达差异。结果 PCT和IL-6联合检测在细菌感染的诊断价值高于PCT和IL-6单项指标的检测价值。D-Dimer和TAT联合检测在血栓形成风险的诊断价值高于D-Dimer和TAT单项指标的检测价值。结论 细菌感染的严重程度与血栓形成的风险呈正相关;采用PCT、IL-6与 D-Dimer、TAT四项联合检测,能同时评估患者细菌感染程度和发生血栓的风险,避免患者因细菌感染而发生血栓,对机体造成更大的伤害,起到早期预警、早期干预、早期治疗的作用。

Utility of D-dimer in total joint arthroplasty

As the number of patients receiving total joint replacements continues to rise,considerable attention has been directed towards the early detection and prevention of postoperative complications.While D-dimer has long been studied as a diagnostic tool in venous thromboembolism(VTE),this assay has recently received considerable attention in the diagnosis of periprosthetic joint infection(PJI).D-dimer values are substantially elevated in the acute postoperative period after total joint arthroplasty,with levels often exceeding the standard institutional cutoff for VTE(500µg/L).The utility of D-dimer in detecting VTE after total joint replacement is currently limited,and more research to assess its value in the setting of contemporary prophylaxis protocols is warranted.Recent literature supports D-dimer as a good to excellent biomarker for the diagnosis of chronic PJI,especially when using serum sample technique.Providers should exercise caution when interpreting D-dimer levels in patients with inflammatory and hypercoagulability disorders,as the diagnostic value is decreased.The updated 2018 Musculoskeletal Infection Society criteria,which includes D-dimer levels>860µg/L as a minor criterion,may be the most accurate for diagnosing chronic PJI to date.Larger prospective trials with transparent lab testing protocols are needed to establish best assay practices and optimal cutoff values for D-dimer in the diagnosis of PJI.This review summarizes the most current literature on the value of D-dimer in total joint arthroplasty and elucidates areas for future progress.

D-Dimer对原发膜性肾病患者预后评价的研究

探讨D-Dimer对原发膜性肾病患者预后评价。方法 收集2022年3月~2023年3月于我院肾内科住院接受肾活检的明确原发性膜性肾病患者50例作为研究对象,观察其年龄(Age)、性别(Sex)、D-二聚体(D-Dimer)、24小时尿蛋白定量(24hUTP)、尿白蛋白/肌酐比值(ACR)、尿红细胞数(RBC)、纤维蛋白原降解产物(FDP)等数据,并选择正常体检者50例作为对照组,收集上述数据进行对比。经免疫治疗后对观察组患者进行预后随访(包括磷脂酶A2受体抗体(PLA2RAb)、D-Dimer、24hUTP、ACR、RBC、FDP等),进行统计分析。结果 与观察组比较,对照组D-Dimer、24hUTP、ACR、RBC、FDP水平较低,差异有统计学意义(P<0.05)。与治疗后比较,治疗前观察组血清PLA2RAb表达、D-Dimer、24hUTP、ACR、RBC、FDP水平较高,差异有统计学意义(P<0.05)。结论 D-Dimer水平检测有助于原发膜性肾病的诊断,具有检测成本低、方便快速等更好的应用价值。

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。

P-selectin表位结构与功能研究进展

Ｐ－ｓｅｌｅｃｔｉｎ是细胞粘附分子选择素家族成员，作为血小板／内皮细胞活化标志和粘附分子，已证明其在介导活化血小板、内皮细胞与白细胞相互粘附作用，参与免疫损伤、炎症反应、血栓形成及肿瘤转移等多种生理、病理过程中发挥重要作用。近年研究表明，Ｐ－ｓｅｌｅｃｔｉｎ分子中不同结构域及其功能表位在其识别、粘附及信号传导中各具重要作用。进一步揭示这种分子构效关系，将有助于阐明Ｐ－ｓｅｌｅｃｔｉｎ的生理、病理意义。

慢性乙肝患者血清可溶性黏附分子P-selectin、ICAM-1与病情变化的相关性研究

目的:探讨慢性乙肝患者血清可溶性黏附分子P-selectin、ICAM-1与病情变化的相关性。方法:119例慢性乙肝患者根据病情严重程度分为慢性乙肝组(n=83,普通慢性乙肝患者)、重症乙肝组(n=36,重症乙肝患者),另取同期在本院进行体检的健康志愿者50例作为正常对照组。对比3组研究对象血清中可溶性黏附分子P-selectin、ICAM-1以及乙肝病毒载量(HBV-DNA)、肝功能指标(AST、ALT、TP、TBil)、肝纤维化指标(CⅣ、HA、LN)的差异,进一步分析慢性乙肝患者血清P-selectin、ICAM-1含量与上述病情指标的内在联系。结果:慢性乙肝组、重症乙肝组患者血清中P-selectin的含量分别高于正常对照组,ICAM-1的含量分别低于正常对照组,随病情加重P-selectin、ICAM-1血清含量改变加剧。慢性乙肝组、重症乙肝组患者血清HBV-DNA水平分别高于正常对照组,且重症乙肝组患者血清HBV-DNA水平更高;重症乙肝组患者血清中AST、ALT、TBil的水平高于慢性乙肝组、正常对照组,TP的水平低于慢性乙肝组、正常对照组;慢性乙肝组、重症乙肝组患者血清中CⅣ、HA、LN的含量分别高于正常对照组,且重症乙肝组患者血清CⅣ、HA、LN含量更高。相关性分析发现,慢性乙肝患者血清中P-selectin、ICAM-1含量与乙肝病毒载量、肝功能、肝纤维化程度均直接相关。结论:P-selectin在慢性乙肝患者血清中含量异常增高,而ICAM-1含量异常下降,其具体血清含量可用于衡量患者病情严重程度。

羟乙葛根素对大鼠局灶性脑缺血再灌注损伤后脑组织E-selectin及P-selectin表达的影响

目的观察E-selectin及P-selectin在羟乙葛根素保护大鼠局灶性脑缺血再灌注损伤中的作用。方法线栓法制备大鼠局灶性脑缺血再灌注损伤模型,大鼠脑缺血2 h再灌注24 h后,采用Western blot及RT-PCR法观察大鼠脑组织E-selectin及P-selectin的蛋白及mRNA表达情况。结果羟乙葛根素可明显降低缺血区脑组织E-selectin及P-selectin的蛋白及mRNA表达。结论羟乙葛根素可能通过降低缺血区脑组织黏附分子表达发挥脑保护作用。

银杏叶提取物对重型颅脑损伤患者血浆P-selectin的影响

目的:研究银杏叶提取物(EGb)对重型颅脑损伤患者血浆P-选择素(P-selectin)的影响。方法:将46例重型颅脑损伤患者随机分为治疗组和对照组,每组23例。治疗组给予EGb加20%甘露醇、胞二磷胆碱等药物常规治疗,对照组仅用20%甘露醇、胞二磷胆碱等常规治疗;观察用药前后患者症状改善程度及血浆P-selectin水平的变化。结果:两组格拉斯格恢复评分(GlasgowOutcomeScale,GOS),治疗组优于对照组(P<0.01)。重型颅脑损伤患者血浆P-selectin治疗前明显高于健康人,治疗后两组患者P-selectin水平均下降,治疗组优于对照组。结论:重型颅脑损伤患者血浆P-selectin水平升高,EGb可降低重型颅脑损伤患者血浆P-selectin水平,可能在一定程度上减轻重型颅脑损伤患者的脑损害。

急性脑梗死后IL-8、Fibulin-5和P-selectin水平及丹红注射液干预效果

目的:探讨丹红注射液对急性脑梗死后IL-8、Fibulin-5和P-selectin水平的影响。方法:选取2012年12月—2014年12月在本院收治的112例急性脑梗死患者为研究对象,采用随机数字表法分为对照组和观察组,对照组患者予常规控制血糖、血压,改善脑循环,保护脑细胞,抑制血小板聚集等常规治疗。观察组患者在对照组基础上联合丹红注射液。比较两组患者神经功能缺损(NIHSS)评分、疗效及血清Fibulin-5、P-selectin、IL-8水平。结果:观察组NIHSS评分由(14.47±3.01)分下降至(3.78±0.57)分,对照组NIHSS评分由(14.51±2.17)分下降至(6.13±0.93)分,治疗前,两组NIHSS评分无差异,治疗后均有所下降,且观察组下降更明显。观察组总有效率为78.57%,高于对照组41.07%,两组患者治疗前P-selectin、Fibulin-5、IL-8比较差异无统计学意义,治疗后较治疗前下降,且观察组更低,比较差异有统计学意义。观察组治疗前后P-selectin为(10.63±1.54)μg/L、(7.65±1.02)μg/L,Fibulin-5为(124.56±22.67)μg/L、(66.31±12.21)μg/L,IL-8为(835.12±123.51)ng/L、(254.12±62.27)ng/L;对照组治疗前后P-selectin为(10.56±2.51)μg/L、(8.24±1.57)μg/L,Fibulin-5为(123.47±24.51)μg/L、(81.67±10.2)μg/L,IL-8为(824.57±135.46)ng/L、(424.52±64.51)ng/L。结论:丹红注射液能够降低急性脑梗死患者血清Fibulin-5、P-selectin、IL-8水平,降低患者神经功能缺损评分,提高疗效。

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。

蒙药嘎日迪-13对脑缺血大鼠不同时相海马中IL-1β IL-8、ICAM-1、P-selectin表达的影响

目的观察蒙药嘎日迪-13对脑缺血大鼠不同时相海马中IL-1β、IL-8、ICAM-1、P-selectin表达的影响。方法 360只雄性SD大鼠随机分为脑缺血模型组、假手术组、嘎日迪-13大、中、小剂量组,每组又随机分为6个时相组,灌胃给药,一次/d,连续27 d后,线栓法制备大鼠大脑中动脉栓塞模型,神经功能评分后免疫组化法测定海马IL-1β、IL-8、ICAM-1、P-selectin的表达。结果嘎日迪-13明显降低脑缺血大鼠神经功能评分,并明显降低脑缺血大鼠海马IL-1β、IL-8、ICAM-1、P-selectin的表达水平。结论蒙药嘎日迪-13对大鼠脑缺血有较好的保护作用,其机制可能与降低IL-1β、IL-8、ICAM-1、P-selectin等因子的表达水平有关。

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。