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Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy
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作者 Taiichiro Miyake Hiroaki Yanagimoto +16 位作者 Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai Toshihiko Yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto 《World Journal of Clinical Cases》 SCIE 2024年第2期276-284,共9页
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... 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. 展开更多
关键词 HEPATECTOMY Malignant tumor Postoperative complication d-dimer Early diagnosis Venous thromboembolism
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Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus
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作者 Ying Zhang Teng Li +1 位作者 Chao-Yan Yue Yun Liu 《World Journal of Diabetes》 SCIE 2024年第5期914-922,共9页
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 th... 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. 展开更多
关键词 Gestational diabetes mellitus d-dimer HEMOGLOBIN Fetal growth restriction Fasting blood glucose
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D-Dimer: Predictor of Postpartum Hemorrhage among Pre-Eclampsia at Kilimanjaro Christian Medical Centre
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作者 Husna Silim Ally Nyasatu G. Chamba +12 位作者 Raziya Gaffur Nasra Batchu Glory Mangi Pendo S. Mlay Bariki Mchome Mtoro J. Mtoro Thomas J. Kakumbi Rafiki N. Mjema Doris Rwenyagila Eusebius Maro Fredrick Mbise Gilleard Masenga Patricia S. Swai 《Open Journal of Obstetrics and Gynecology》 2024年第6期923-937,共15页
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... 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. 展开更多
关键词 d-dimer PREECLAMPSIA Postpartum Hemorrhage Tanzania
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Analysis of the Role of D-Dimer,Interleukin-6,and Interleukin-18 in Differential Diagnosis of Pediatric Refractory Mycoplasma pneumoniae Pneumonia
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作者 Yong Peng Aimin Li 《Journal of Clinical and Nursing Research》 2024年第7期118-122,共5页
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 w... 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. 展开更多
关键词 Refractory Mycoplasma pneumoniae pneumonia d-dimer INTERLEUKIN-6 INTERLEUKIN-18 Differential diagnosis
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Correlation Analysis Between Changes of D-Dimer Level and Rheumatoid Arthritis Complicated with Interstitial Lung Disease
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作者 Ying Li 《Journal of Clinical and Nursing Research》 2024年第6期393-397,共5页
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 ... 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. 展开更多
关键词 d-dimer Rheumatoid arthritis complicated with interstitial lung disease ESR Rheumatoid factor Correlation analysis
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探讨NLR、PLR、hs-CRP、Hb、D-D与ACI非溶栓治疗后出血性转化的相关性分析
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作者 张玫娜 郭志鹏 曹扬 《脑与神经疾病杂志》 2024年第1期26-30,共5页
目的 探讨急性脑梗死患者(ACI)非溶栓治疗前血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、D-二聚体(D-D)与治疗后出血性转化(HT)的相关性,以期为临床预防ACI非溶栓治疗后发生... 目的 探讨急性脑梗死患者(ACI)非溶栓治疗前血清中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、D-二聚体(D-D)与治疗后出血性转化(HT)的相关性,以期为临床预防ACI非溶栓治疗后发生提供指导依据。方法 本研究病历组(设为转化组)共纳入80例样本,选取自2015年1月至2019年12月在吉林大学第一医院检验科接受非溶栓治疗后并出现HT的ACI患者,根据HT严重程度等级化分1级、2级、3级、4级,各严重程度患者分别为27例、22例、18例、13例。选取50例在接受非溶栓治疗后未出现HT的ACI患者作为对照(非转化组)。比较各组的血清NLR、PLR、hs-CRP、Hb、D-D表达水平差异,并通过Spearman秩相关检验分析NLR、PLR、hs-CRP、Hb、D-D与HT严重程度的相关性。并采用ROC曲线分析NLR、PLR、hsCRP、Hb、D-D对ACI患者HT的预测作用。结果 转化组的血清NLR、PLR、hs-CRP、D-D表达水平均高于非转化组,Hb的表达水平低于非转化组(均P<0.05)。1级、2级、3级、4级患者的血清NLR、PLR、hs-CRP、D-D表达水平依次上升,Hb表达水平依次降低,差异有统计学意义(P<0.05),且组间两两比较,差异有统计学意义(P<0.05)。ACI非溶栓治疗后HT严重程度与血清NLR、PLR、hs-CRP、D-D均呈正相关(r值分别为:0.729、0.692、0.601、0.578,均P<0.05),与Hb呈负相关(r值为:-0.678,P<0.05)。ROC曲线分析显示,NLR的AUC值为0.896[95%CI(0.737~0.962)]、PLR的AUC值为0.775 [95%CI(0.626~0.917)]、hs-CRP的AUC值为0.840 [95%CI(0.712~0.948)]、Hb的AUC值为0.782 [95%CI(0.493~0.914)]、D-D的AUC值为0.725 [95%CI(0.403~0.852)]。结论 ACI患者的NLR值、PLR值、hs-CRP、Hb、D-D表达水平与其在非溶栓治疗后发生HT存在相关性,临床上可将这些指标作为预测HT风险。 展开更多
关键词 NLR PLR HS-CRP HB d-d 急性脑梗死 出血性转化
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CRP和D-D对急性心肌梗死并发心房颤动的预测价值
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作者 倪文伟 《生命科学仪器》 2024年第1期111-113,共3页
目的探讨血清C反应蛋白(CRP)与D-二聚体(D-D)在急性心肌梗死并发心房颤动风险评估中的预测价值。方法选取2020年1月至2022年12月期间南通瑞慈医院收治的60例急性心肌梗死患者,按照是否并发心房颤动分为研究组和对照组,各30例。比较两组... 目的探讨血清C反应蛋白(CRP)与D-二聚体(D-D)在急性心肌梗死并发心房颤动风险评估中的预测价值。方法选取2020年1月至2022年12月期间南通瑞慈医院收治的60例急性心肌梗死患者,按照是否并发心房颤动分为研究组和对照组,各30例。比较两组患者血清CRP与D-D水平。采用Logistic回归分析急性心肌梗死并发心房颤动的危险因素。结果研究组患者D-D水平明显低于对照组,CRP水平则明显升高(P<0.05)。Logistic回归分析表明,患者年龄、糖尿病、D-D和CRP与急性心肌梗死并发心房颤动存在显著关联(P<0.05)。此外,这两项指标与左心房前后均呈正相关,具有预测急性心肌梗死患者并发心房颤动的诊断价值。结论血清CRP与D-D在评估急性心肌梗死并发心房颤动发生风险中具有一定的临床价值,有利于评估患者病情的严重程度。 展开更多
关键词 急性心肌梗死 心房颤动 CRP d-d 风险评估
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FDP、D-D联合PLT预测创伤性凝血病患者生存预后的效能分析
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作者 王娅鑫 钱净 +5 位作者 杨文迪 朗迪 马永鑫 张鸿伟 黎海生 赵晓丽 《中国临床新医学》 2024年第5期538-542,共5页
目的分析纤维蛋白原降解产物(FDP)、D-二聚体(D-D)联合血小板(PLT)预测创伤性凝血病(TIC)患者生存预后的效能。方法回顾性收集2020年2月至2023年2月昆明市第一人民医院收治的182例创伤患者的临床资料,根据TIC发生情况将其分为TIC组(85例... 目的分析纤维蛋白原降解产物(FDP)、D-二聚体(D-D)联合血小板(PLT)预测创伤性凝血病(TIC)患者生存预后的效能。方法回顾性收集2020年2月至2023年2月昆明市第一人民医院收治的182例创伤患者的临床资料,根据TIC发生情况将其分为TIC组(85例)和非TIC组(97例)。比较两组临床资料,采用多因素logistic回归分析探讨TIC患者入院时FDP、D-D、PLT水平对入院后30 d内死亡发生的影响,并采用受试者工作特征(ROC)曲线分析探讨上述指标的预测效能。结果TIC组创伤严重程度评分(ISS)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶原时间比值(PTR)、国际标准化比值(INR)水平以及死亡发生率高于非TIC组,纤维蛋白原(Fib)、PLT、血红蛋白(Hb)水平低于非TIC组,差异有统计学意义(P<0.05)。TIC患者入院后30 d内存活59例,死亡26例。存活组FDP、D-D水平显著低于死亡组(P<0.05),PLT水平显著高于死亡组(P<0.05),两组Fib水平比较差异无统计学意义(P>0.05)。经调整年龄、性别、住院时间、ISS因素后,多因素logistic回归分析结果显示,FDP[OR(95%CI)=1.021(1.007~1.036)]、D-D[OR(95%CI)=1.087(1.027~1.250)]水平升高是促进TIC患者发生死亡的危险因素(P<0.05),PLT[OR(95%CI)=0.990(0.983~0.997)]水平升高是抑制TIC患者发生死亡的保护因素(P<0.05)。ROC曲线分析结果显示,FDP、D-D、PLT可有效预测TIC患者入院30 d内死亡(P<0.05),且三项指标联合的预测效能更高[AUC(95%CI)=0.823(0.720~0.925),P<0.001]。结论入院时检测FDP、D-D、PLT指标有助于评估TIC患者的生存预后情况,值得临床医师关注。 展开更多
关键词 创伤性凝血病 生存预后 纤维蛋白原降解产物 D-二聚体 血小板
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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 被引量:1
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作者 路娟 何凤 《贵州医药》 CAS 2023年第1期116-117,共2页
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... 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。 展开更多
关键词 产后出血 凝血功能四项 d-dimer FDP
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基于D-D中子源开展^(238)U样品屏蔽积分实验研究
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作者 丁琰琰 聂阳波 +8 位作者 胡志杰 赵齐 张环宇 徐阔之 张时宇 潘欣怡 兰长林 任杰 阮锡超 《原子能科学技术》 EI CAS CSCD 北大核心 2024年第5期970-981,共12页
利用中国原子能科学研究院的中子学屏蔽积分实验装置,通过飞行时间法分别测量了D-D中子源与不同尺寸^(238)U样品作用后在60°和120°的泄漏中子谱,样品表面积为30 cm×30 cm的板状样品,厚度分别为3、6和9 cm。利用蒙特卡罗... 利用中国原子能科学研究院的中子学屏蔽积分实验装置,通过飞行时间法分别测量了D-D中子源与不同尺寸^(238)U样品作用后在60°和120°的泄漏中子谱,样品表面积为30 cm×30 cm的板状样品,厚度分别为3、6和9 cm。利用蒙特卡罗程序对泄漏中子谱进行了模拟计算,其中^(238)U数据分别采用CENDL-3.2库、ENDF/B-Ⅷ.0库、JENDL-5.0库和JEFF-3.3库中的数据。通过对模拟结果与实验结果的比较,重点分析了CENDL-3.2库中^(238)U数据存在的不足和需要改进之处,结果表明:在裂变反应能区内,CENDL-3.2库计算结果与实验结果符合较好,但在弹性散射能区60°和120°均有较大的高估,尤其是120°,而在裂变反应和分立能级非弹性散射的混合能区1.5~2.5 MeV又有明显低估。 展开更多
关键词 泄漏中子谱 d-d中子源 飞行时间法 评价核数据
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PCT、D-D联合CRP水平动态检测在脓毒症分级及转归评估中的意义
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作者 赵静媛 张玉红 +4 位作者 董龙 吴雪 段立娟 严晓薇 李素清 《分子诊断与治疗杂志》 2024年第5期894-898,903,共6页
目的探讨PCT、D-D联合CRP水平动态检测在脓毒症分级及转归评估中的意义。方法选取2020年5月至2023年1月承德医学院附属医院收治的112例脓毒症患者设为观察组,另随机选取同期本院进行体检的105名健康人群作为对照组。根据病情严重程度将... 目的探讨PCT、D-D联合CRP水平动态检测在脓毒症分级及转归评估中的意义。方法选取2020年5月至2023年1月承德医学院附属医院收治的112例脓毒症患者设为观察组,另随机选取同期本院进行体检的105名健康人群作为对照组。根据病情严重程度将112例脓毒症患者分为脓毒症组(n=49)、严重脓毒症组(n=35)和脓毒症休克组(n=28),统计患者28d天后生存结局。比较观察组和对照组、不同脓毒症分级患者PCT、D-D、CRP水平及序贯器官衰竭评分(SOFA)、急性生理与慢性健康评分(APACHEⅡ),分析PCT、D-D、CRP水平与SOFA评分、APACHEⅡ评分的相关性以及PCT、D-D、CRP水平及三者联合对脓毒症的预后预测价值。结果观察组PCT、D-D、CRP水平均高于对照组,差异有统计学意义(P<0.05);不同时间点(入院时、入院3 d、入院5 d、入院7 d)脓毒症休克组PCT、D-D、CRP水平和SOFA评分、APACHEⅡ评分均高于脓毒症组和严重脓毒症组,差异有统计学意义(P<0.05);严重脓毒症组PCT、D-D、CRP水平和SOFA评分、APACHEⅡ评分均高于脓毒症组,差异有统计学意义(P<0.05);根据随访患者28 d天后生存结局分为存活组和死亡组,存活组不同时间点(入院时、入院3 d、入院5 d、入院7 d)PCT、D-Dz、CRP水平和SOFA评分、APACHEⅡ评分均低于死亡组,差异有统计学意义(P<0.05);脓毒症患者PCT、D-D、CRP水平与SOFA评分、APACHEⅡ评分均呈正相关性(P值均<0.05);ROC曲线显示,入院28 d后,PCT、D-D、CRP及三者联合预测脓毒症患者预后情况的AUC分别为0.830、0.7230、0.765、0.934,三者联合的预测价值更大(P<0.05)。结论PCT、D-D联合CRP水平动态检测可以反映患者病情严重程度和转归情况,可作为脓毒症分级参考指标。 展开更多
关键词 脓毒症 PCT d-d CRP
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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
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作者 刘丹丹 李敏 +1 位作者 王奎 王亚洲 《中文科技期刊数据库(引文版)医药卫生》 2023年第4期54-58,共5页
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(CL... 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。 展开更多
关键词 炎症 血栓 联合检测 PCT IL-6 d-dimer TAT
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血清Hcy、CysC、D-D水平与急性缺血性脑卒中患者病情及静脉溶栓后短期预后的关系研究
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作者 汪文静 李丽娜 王继存 《医学分子生物学杂志》 CAS 2024年第4期380-385,共6页
目的探讨血清同型半胱氨酸(homocysteine,Hcy)、胱抑素C(cystatin C,CysC)和D-二聚体(D-dimer,D-D)水平与急性缺血性脑卒中(acute ischemic stroke,AIS)患者的病情及静脉溶栓后短期预后之间的关系。方法选取2019年10月至2023年6月在北... 目的探讨血清同型半胱氨酸(homocysteine,Hcy)、胱抑素C(cystatin C,CysC)和D-二聚体(D-dimer,D-D)水平与急性缺血性脑卒中(acute ischemic stroke,AIS)患者的病情及静脉溶栓后短期预后之间的关系。方法选取2019年10月至2023年6月在北京市顺义区医院接受静脉溶栓治疗的AIS患者100例,根据美国国立卫生研究院卒中量表评分(National Institutes of Health Stroke Scale,NIHSS)分为轻度缺损组(1~4分)44例,中度缺损组(5~15分)29例,重度缺损组(16~42分)27例;根据脑梗死体积分为小梗死组(<5 cm3)40例,中度梗死组(5~15 cm3)37例,大梗死组(>15 cm3)23例。静脉溶栓治疗后3个月,根据改良Rankin量表评分分为预后良好组(≤2分)75例和预后不良组(>2分)25例。收集患者基线数据,检测血清Hcy、CysC和D-D水平。对比不同神经功能缺损程度、脑梗死体积、短期预后的AIS患者血清Hcy、CysC和D-D水平变化,使用Pearson相关系数分析血清Hcy、CysC、D-D水平与AIS病情的相关性。采用logistic回归分析影响AIS短期预后的危险因素。采用受试者工作特征曲线(receiver operating characteristic,ROC)分析血清Hcy、CysC、D-D水平预测AIS静脉溶栓后短期预后的价值。结果轻度缺损组血清Hcy、CysC、D-D水平最低,其次为中度缺损组,重度缺损组最高,组间比较差异有统计学意义(P<0.05)。小梗死组血清Hcy、CysC、D-D水平最低,其次为中度梗死组,大梗死组最高,组间比较差异有统计学意义(P<0.05)。Pearson相关分析显示,血清Hcy、CysC、D-D水平与NHISS评分呈正相关(r=0.424、0.573、0.716,P均<0.001),与脑梗死体积也呈正相关(r=0.633、0.479、0.548,P均<0.001)。单因素分析显示,预后良好组血清Hcy、CysC和D-D水平均低于预后不良组(P均<0.05)。多元logistic回归分析显示,Hcy、CysC和D-D(OR=1.093、1.343、1.146)是AIS短期预后的独立预测因素(P<0.05)。ROC曲线分析显示,血清Hcy、CysC、D-D及3者联合预测AIS短期预后的曲线下面积分别为0.853、0.873、0.792、0.946,以3者联合的预测价值最高。结论血清Hcy、CysC、D-D水平与AIS患者病情程度呈正相关,可用于评估AIS患者静脉溶栓后短期预后。 展开更多
关键词 Hcy CYSC d-d 急性缺血性脑卒中 病情程度 短期预后
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Utility of D-dimer in total joint arthroplasty
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作者 Brenden Cutter Zachary C Lum +1 位作者 Mauro Giordani John P Meehan 《World Journal of Orthopedics》 2023年第3期90-102,共13页
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 ... 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. 展开更多
关键词 d-dimer DIAGNOSIS Periprosthetic joint infection Venous thromboembolism Deep vein thrombosis ARTHROPLASTY
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利伐沙班、华法林对ACS患者介入治疗后NT-proBNP、D-D及Fg水平的影响
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作者 夏俊涛 李峰 +4 位作者 余快 胡丽 陈黎 周乐玲 田林 《分子诊断与治疗杂志》 2024年第6期1130-1133,1142,共5页
目的 分析利伐沙班、华法林对急性冠脉综合征(ACS)患者介入治疗后N端B型脑钠肽前体(NT-proBNP)、D-二聚体(D-D)及纤维蛋白原(Fg)水平的影响。方法 选取武胜县人民医院2020年7月至2023年2月期间收治的行经皮冠状动脉介入治疗的ACS患者142... 目的 分析利伐沙班、华法林对急性冠脉综合征(ACS)患者介入治疗后N端B型脑钠肽前体(NT-proBNP)、D-二聚体(D-D)及纤维蛋白原(Fg)水平的影响。方法 选取武胜县人民医院2020年7月至2023年2月期间收治的行经皮冠状动脉介入治疗的ACS患者142例,遵循单盲法原则,根据治疗方案不同分为对照组70例(予以华法林治疗)与观察组72例(予以利伐沙班治疗)。对比两组临床疗效、血脂水平[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、NT-proBNP、D-D、Fg水平,比较两组随访期间出现的心血管不良事件以及用药期间的不良反应发生情况。结果 观察组治疗后的临床有效率高于对照组,差异有统计学意义(P<0.05);治疗3个月后,两组TG、TC、LDL-C、HDL-C水平均下降,且观察组低于对照组,差异有统计学意义(P<0.05);治疗3个月后,两组NT-proBNP、D-D、Fg水平均下降,且观察组低于对照组,差异有统计学意义(P<0.05);观察组在治疗期间出现的心血管不良事件的总发生率低于对照组,差异有统计学意义(P<0.05);观察组在用药期间出现的不良反应的总发生率低于对照组,差异有统计学意义(P<0.05)。结论 在ACS患者介入治疗后,应用利伐沙班的治疗效果相对更为显著,其可有效改善患者血脂水平、凝血功能,减少心血管不良事件的发生风险,且具有一定的安全性。 展开更多
关键词 利伐沙班 华法林 ACS 介入治疗 NT-PROBNP d-d FG
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血清Hcy、D-D、IL-17水平与脑梗死患者病情及预后的相关性分析
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作者 郭会月 王欣格 靳玫 《四川生理科学杂志》 2024年第8期1720-1722,1789,共4页
目的:分析血清同型半胱氨酸(Homocysteine,Hcy)、D二聚体(D-dimer,D-D)、白介素-17(Interleukin-17,IL-17)水平与脑梗死患者病情及预后的相关性。方法:2020年11月至2023年2月择取我院脑梗死患者96例作为研究组,择取同期健康体检者96例... 目的:分析血清同型半胱氨酸(Homocysteine,Hcy)、D二聚体(D-dimer,D-D)、白介素-17(Interleukin-17,IL-17)水平与脑梗死患者病情及预后的相关性。方法:2020年11月至2023年2月择取我院脑梗死患者96例作为研究组,择取同期健康体检者96例作为对照组;随访6个月,根据改良Rankin量表评估患者预后,分为预后良好和预后不良患者。对比两组入院时及不同神经功能缺损程度、不同脑梗死病灶面积患者入院时血清各指标水平,并分析其相关性;对比不同预后患者入院时血清各指标水平,分析入院时血清各指标水平对脑梗死患者预后不良的预测价值。结果:研究组入院时血清Hcy、D-D、IL-17水平显著高于对照组(P<0.05);不同神经缺损程度、不同梗死面积患者入院时血清Hcy、D-D、IL-17水平比较,轻度<中度<重度、腔隙性梗死<小面积梗死<大面积梗死患者(P<0.05);入院时血清Hcy、D-D、IL-17均与神经缺损程度、脑梗死病灶面积均呈正相关(P<0.05);预后不良患者血清Hcy、D-D、IL-17水平显著高于预后良好患者(P<0.05);入院时血清Hcy、D-D、IL-17水平联合预测脑梗死患者预后不良的曲线下面积为0.788。结论:脑梗死患者血清Hcy、D-D、IL-17水平与病情程度及预后密切相关,认为临床检测其表达可作为评估患者病情及预后的有效指标,辅助临床诊疗。 展开更多
关键词 HCY d-d IL-17 脑梗死 预后
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D-Dimer对原发膜性肾病患者预后评价的研究
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作者 沈婕 《中文科技期刊数据库(引文版)医药卫生》 2023年第9期33-35,共3页
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/... 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。 展开更多
关键词 d-dimer 原发膜性肾病 预后
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Manipulating d-d orbital hybridization induced by Mo-doped Co_(9)S_(8) nanorod arrays for high-efficiency water electrolysis
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作者 Xue Zhou Jing Li +8 位作者 Guangyao Zhou Weiran Huang Yucan Zhang Jun Yang Huan Pang Mingyi Zhang Dongmei Sun Yawen Tang Lin Xu 《Journal of Energy Chemistry》 SCIE EI CAS CSCD 2024年第6期592-600,I0015,共10页
Precisely refining the electronic structure of electrocatalysts represents a powerful approach to further optimize the electrocatalytic performance.Herein,we demonstrate an ingenious d-d orbital hybridization concept ... Precisely refining the electronic structure of electrocatalysts represents a powerful approach to further optimize the electrocatalytic performance.Herein,we demonstrate an ingenious d-d orbital hybridization concept to construct Mo-doped Co_(9)S_(8) nanorod arrays aligned on carbon cloth(CC)substrate(abbreviated as Mo-Co_(9)S_(8)@CC hereafter)as a high-efficiency bifunctional electrocatalyst toward water electrolysis.It has experimentally and theoretically validated that the 4d-3d orbital coupling between Mo dopant and Co site can effectively optimize the H_(2)O activation energy and lower H^(*)adsorption energy barrier,thereby leading to enhanced hydrogen evolution reaction(HER)and oxygen evolution reaction(OER)activities.Thanks to the unique electronic and geometrical advantages,the optimized Mo-Co_(9)S_(8)@CC with appropriate Mo content exhibits outstanding bifunctional performance in alkaline solution,with the overpotentials of 75 and 234 mV for the delivery of a current density of 10 mA cm^(-2),small Tafel slopes of 53.8 and 39.9 mV dec~(-1)and long-term stabilities for at least 32 and 30 h for HER and OER,respectively.More impressively,a water splitting electrolylzer assembled by the self-supported Mo-Co_(9)S_(8)@CC electrode requires a low cell voltage of 1.53 V at 10 mA cm^(-2)and shows excellent stability and splendid reversibility,demonstrating a huge potential for affordable and scalable electrochemical H_(2) production.The innovational orbital hybridization strategy for electronic regulation herein provides an inspirable avenue for developing progressive electrocatalysts toward new energy systems. 展开更多
关键词 d-d orbital hybridization Transition metal sulfides Nanorods arrays Water electrolysis
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d-d Orbital coupling induced by crystal-phase engineering assists acetonitrile electroreduction to ethylamine
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作者 Honggang Huang Yao Chen +7 位作者 Hui Fu Cun Chen Hanjun Li Zhe Zhang Feili Lai Shuxing Bai Nan Zhang Tianxi Liu 《Journal of Energy Chemistry》 SCIE EI CAS CSCD 2024年第2期216-225,I0006,共11页
The d-d orbital coupling induced by crystal-phase engineering can effectively adjust the electronic structure of electrocatalysts,thus showing significant catalytic performance,while it has been rarely explored in ele... The d-d orbital coupling induced by crystal-phase engineering can effectively adjust the electronic structure of electrocatalysts,thus showing significant catalytic performance,while it has been rarely explored in electrochemical acetonitrile reduction reaction(ARR)to date.Herein,we successfully realize the structural transformation of Pd Cu metallic aerogels(MAs)from face-centered cubic(FCC)to body-centered cubic(BCC)through annealing treatment.Specifically,the BCC Pd Cu MAs exhibit excellent ARR performance with high ethylamine selectivity of 90.91%,Faradaic efficiency of 88.60%,yield rate of 316.0 mmol h^(-1)g^(-1)_(Pd+Cu)and long-term stability for consecutive electrolysis within 20 h at-0.55 V vs.reversible hydrogen electrode,outperforming than those of FCC Pd Cu MAs.Under the membrane electrode assembly system,BCC Pd Cu MAs also demonstrate excellent ethylamine yield rate of 389.5 mmol h^(-1)g^(-1)_(Pd+Cu).Density functional theory calculation reveals that the d-d orbital coupling in BCC Pd Cu MAs results in an evident correlation effect for the interaction of Pd and Cu sites,which boosts up the Cu sites electronic activities to enhance ARR performance.Our work opens a new route to develop efficient ARR electrocatalysts from the perspective of crystalline structure transformation. 展开更多
关键词 d-d Orbital coupling Crystal-phase engineering Metallic aerogels Acetonitrile electroreduction reaction ETHYLAMINE
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下肢骨折术后D-D及凝血四项指标预测并发深静脉血栓风险的价值
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作者 王祝青 马娟娟 郑斌 《贵州医药》 CAS 2024年第8期1296-1297,共2页
目的探讨D-D联合凝血四项指标预测下肢骨折并发DVT的临床价值。方法将98例行下肢骨折手术治疗的患者根据是否发生DVT分为研究组(发生DVT)和参照组(未发生DVT)各49例。对比两组患者凝血四项指标、血清D-D水平,对下肢骨折患者DVT形成的危... 目的探讨D-D联合凝血四项指标预测下肢骨折并发DVT的临床价值。方法将98例行下肢骨折手术治疗的患者根据是否发生DVT分为研究组(发生DVT)和参照组(未发生DVT)各49例。对比两组患者凝血四项指标、血清D-D水平,对下肢骨折患者DVT形成的危险因素进行Logistic回归分析。结果研究组TT、PT、APTT均短于参照组,D-D、FIB水平均高于参照组(P<0.05);Logistic结果显示,D-D、FIB水平上升是造成下肢骨折DVT发生的危险因素,PT、TT和APTT延长是造成下肢骨折DVT的保护因素(P<0.05)。结论D-D与凝血四项指标对预测下肢骨折DVT发生有较高的诊断价值,因此,临床上还要加强对下肢骨折手术患者的D-D、凝血四项指标进行监测,以便尽早发现下肢DVT,及时对患者实施合理有效的治疗。 展开更多
关键词 d-d 凝血四项指标 下肢骨折 深静脉血栓 诊断价值
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